Living with Cancer
Eating well during cancer treatment - Kia pai te kai i te wā maimoatanga matepukupuku
A guide for eating well during treatment
Adapted in accordance with Section 69 of the Copyright Act 1994 by the Royal New Zealand Foundation of the Blind, for the sole use of persons who have a print disability.
Produced 2012 by Accessible Format Production, RNZFB, Auckland
This edition is a transcription of the following print edition:
Published by The Cancer Society
Copyright 2012 Cancer Society of New Zealand Inc,
PO Box 12700, Wellington.
Fifth Edition 2007 ISBN 0-908933-70-3
Sixth Edition 2012 ISBN 0-908933-92-4
Omissions
All images are omitted from this copy of Living with Cancer: Eating well during cancer treatement – Kia pai te kai I te wā maimoatanga matepukupuku.
Publications Statement
The Cancer Society’s aim is to provide easy-to-understand and accurate information on cancer, its treatments, and the support available.
Our Living with Cancer information booklets are reviewed every four years by cancer doctors, specialist nurses, and other relevant health professionals to ensure the information is reliable, evidence-based, and up-to-date. The booklets are also reviewed by consumers to ensure they meet the needs of people with cancer.
Other titles from the Cancer Society of New Zealand / Te Kāhui Matepukupuku o Aotearoa Booklets
Advanced Cancer/Matepukupuku Maukaha
Bowel Cancer/Matepukupuku Puku Hamuti
Bowel Cancer and Bowel Function: Practical advice
Breast Cancer/Te Matepukupuku o nga-Ū
Breast Cancer in Men: From one man to another
Cancer Clinical Trials
Cancer in the Family: Talking to your children
Chemotherapy/Hahau
Complementary and Alternative Medicine
Eating Well During Cancer Treatment
Emotions and Cancer
Got Water?/He Wai?
Lung Cancer/Matepukupuku Pūkahukahu
Melanoma/Tonapuku
Prostate Cancer/Matepukupuku Repeure
Radiation Treatment/Haumanu Iraruke
Secondary Breast Cancer/Matepukupuku Tuarua ā-Ū
Sexuality and Cancer/Hōkakatanga me te Matepukupuku
Understanding Grief/Te Mate Pāmamae
Brochures
Being Active When You Have Cancer
Being Breast Aware
Bowel Cancer Awareness
Gynaecological Cancers
Questions You May Wish to Ask
Talking to a Friend with Cancer
Thermography
This edition of Eating Well During Cancer Treatment/ Kia Pai te Kai i te Wā Maimoatanga Matepukupuku includes a new feature in response to suggestions from those who review our booklets, and to meet the needs of our readers. Our key messages and important sections have been translated into te Reo Māori. Our translations have been provided by Hohepa MacDougall, of Wharetuna Māori Consultancy Services and have been peer reviewed by his colleagues.
Page 1
Eating well during cancer treatment
This booklet has been prepared to help you with questions you may have about your diet while undergoing cancer treatment. It will help you to deal with any eating problems caused by your cancer or by your treatment.
You might like to pass this booklet on to your family/whānau and friends.
Box:
Kia pai te kai i te wā maimoatanga matepukupuku
I whakaritea te pukapuka nei hei āwhina i a koe ki te whakautu i ngā pātai tērā pea ka ara ake e pā ana ki tō nohopuku i te wā e whakamahia ana ngā maimoatanga matepukupuku. Ka āwhina hoki i a koe e whaihanga ana i ngā raruraru ka ara ake nā tō mate, nā tō maimoatanga rānei.
Tērā pea ka pīrangi koe ki te hoatu i te pukapuka nei ki tō whānau, ki ō hoa rānei.
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Page 2
Contents
Eating well, feeling better – Page 3
What is a healthy diet? – Page 5
Food safety – Page 17
Staying the same weight – Page 19
Foods high in calories (energy) and protein – Page 20
Adding to what you can eat (nutritional supplement drinks) - Page 24
Eating problems – Page 26
Loss of appetite (not feeling hungry) – Page 27
Nausea (feeling sick) – Page 28
Taste and smell changes – Page 30
Mouth or swallowing problems – Page 32
Dry mouth – Page 34
Making food easier to eat – Page 36
Soft foods – Page 36
Pureed foods (food with no lumps) – Page 38
Bowel problems – Page 42
Constipation (hard bowel motions) – Page 42
Diarrhoea (loose bowel motions) – Page 44
What is a low fibre diet? – Page 45
Eating a low residue diet – Page 47
Intolerance to some foods (food that makes you feel unwell) – Page 48
Fatigue – Page 48
Easy ways to make meals – Page 49
Recipes – Page 50
Suggested reading and websites – Page 65
Notes – Page 67
Feedback – Page 71
Page 3
Eating well, feeling better
Eating good food is important when you are well, and it is also very important when you are receiving treatment for cancer.
It is important that you eat well so that you will:
• feel better and have more energy
• get the most benefit from your treatment with fewer side effects
• improve your body’s ability to heal, and to fight infection
• maintain a healthy weight.
If you are thinking about making a dramatic change to your diet, look at your choices closely and discuss them with your cancer doctor or dietitian.
Once a cancer has developed it cannot be cured through diet alone. Many unproven dietary treatments, particularly those that cut out whole food groups, such as meat or dairy, may not provide enough energy (calories or kilojoules), protein, or essential nutrients. This can cause unwanted weight loss, tiredness, and decrease your immune function. Your recovery and quality of life can improve if you eat a healthy diet.
There is no evidence to support claims that special diets or single nutrients, such as a particular vitamin, can cure cancer. Some diets or nutrients do no harm, but there are some that are harmful and can interfere with the success of your treatment.
Page 4
Box:
Kia pai te kai, kia ora ake ai
He mea nui te kai i ngā kai pai i a koe e noho ora ana, ā, he pērā anō hoki i te wā e whai maimoatanga ana koe mō te matepukupuku.
He mea nui rawa atu kei te kai pai koe:
• kia piki te ora ki a koe, kia whai kaha hoki
• kia puta ngā painga o tō maimoatanga, me te iti ake o ngā pānga kino
• kia pai ake tō tinana ki ngā mahi whakaora, me te patu i te mate urutā
• kia noho hauora ai te taumaha o tō tinana.
Mehemea kei te whakaaro koe ki te tino whakarerekē i tō nohopuku, āta tirohia ō kōwhiringa ka korero ki tō rata ki tō mātanga nohopuku rānei.
Ka pā ana te matepukupuku, ehara i te mea ka ora te tangata mā te kai pai anake. He nui ngā maimoatanga nohopuku korehua, kāre e pai mō te whakarato pūngao, (pūngoi, he kilojoules rānei), pūmua me ngā whakamōmona tino matua, tae noa ki ngā nohopuku whakakore i te katoa o tētahi momo kai, pērā ki te whakakore i te kai mīti, i ngā kai ahu mai i te miraka. Mā tēnei, tērā pea ka heke rawa te taumaha o te tangata, ka tere māuiuitia rānei me te heke iho o te mahi whakatō ārai mate.
Ka pai ake tō whakamāui me tō oranga mehemea ka whai koe i tētahi nohopuku hauora. Kāore he kōrero pono hei tautoko i taua whakaaro, ka ora ake te tangata i te matepukupuku mā te kai motuhake, mā tētahi momo whakamōmona rānei pērā i tētahi hauora hāngai.
Page 5
Ehara i te mea he kino ētahi o ngā kai nohopuku motuhake ngā whakamōmona rānei, heoi, arā etahi momo kāore i te pai ā, tērā pea ka whakararu i tō maimoatanga.
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What is a healthy diet?
Choosing a wide variety of healthy foods is something very positive that you can do to help you feel stronger and maintain a healthy weight.
You can check how you are doing by following these guidelines, which will provide all the nutrients you need. If what you usually eat includes foods that are not listed, talk to your treatment team.
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He aha hoki te kai tōtika?
Ko te kai i te maha o ngā momo kai huaora tētahi mea pai hei āwhina i a koe kia pakari ake, ā, kia pai hoki te haere o tō taumahatanga.
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Every day you need: Ia rā, ia rā me whai koe i ēnei:
Calories (energy) / Ngā pūngoi (pūngao)
Calories provide fuel for your body to do daily activities and maintain body weight.
Pages 6 - 7
Calories (energy) are provided by: Protein / Pūmua
Protein maintains and renews your body tissues and helps your body defend itself against infection.
The American Institute of Cancer Research also has recommendations on healthy eating. To view these recommendation, visit the Institute’s website:
http://www.aicr.org/new-american-plate/
Sources of protein are: Ahu mai ai te pūmua i:
Milk and milk products: Te waiū me ngā hua waiū
Have at least two servings of milk or milk products a day.
One serving is:
• a glass of milk
• or two slices of cheese
• or a pottle of yoghurt or dairy food.
You can also choose cottage cheese, soft cheeses, ice cream, or milk puddings. Milk and milk products are a valuable source of calcium for bone health.
See page 50 for our fruit smoothie recipe.
Page 8
Meats, poultry, fish, eggs (animal protein) - Mīti, heihei, ika, hēki (pūmua kararehe)
Have at least one serving a day. Choose meat, chicken, fish (a serving size is equal to the size of your palm or two cooked eggs, or two drumsticks).
Meat, chicken, and fish also provide iron and zinc. Use low fat cooking methods, such as stewing, baking, microwaving, grilling, slow cooking, or poaching.
See page 52 for our quick and easy wraps recipe.
Page 9
Nuts and pulses (plant protein) - Nati me ngā kai kākano nei te āhua (pūmua tipu)
Have at least one serving a day. Choose nuts and pulses (dried beans, peas, and lentils); for example baked beans, tofu, lentil burgers, bean salad, and lentil soup. A serving size is equal to ¾ cup of cooked legumes.
Pages 10 - 11
Carbohydrates / Warowaihā
Carbohydrates provide fibre, vitamins (for example vitamin C), and minerals, such as selenium. They are an important source of energy.
Breads and cereals - Parāoa me ngā pata kai
Try to have six servings of breads and cereals each day. These foods should form the basis of most meals and snacks.
Serving size examples are:
• ½ cup of cooked cereal or muesli, or one cup of cornflakes
• one cup of cooked rice, couscous, polenta, or pasta
• one roll, muffin, or slice of bread.
Also try semolina, sago, pikelets, scones, crackers, roti, chapatti, naan, plain biscuits, and other products made from grains. Ideally, they should be wholemeal or wholegrain, if tolerated, for additional fibre.
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Vegetables and fruits - Ngā huawhenua me ngā huarākau
Have at least five servings of vegetables and fruits each day. Vegetables and fruits provide a wide range of vitamins and minerals, as well as carbohydrates and fibre. Include a variety of colours and choose fresh, frozen, stewed, or canned. Serving size examples are:
• one medium potato, kumara, carrot, or equivalent piece of pumpkin, taro, or yams
• ½ cup of cooked vegetables; for example broccoli, peas, silverbeet, spinach, corn, peppers, carrot, courgette, cauliflower, cabbage, Brussels sprouts, bean sprouts, lettuce, puha, or watercress
• one tomato or a cup of salad
• one apple, pear, banana, or orange; two apricots, plums, kiwifruit, or mandarins, 1/2 cup of fresh, canned, or stewed fruits; three prunes, dates, or dried apricots.
See pages 54 to 57 for our roast vegetable medley and Waldorf salad with a difference recipes.
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Fats
Eat less of these foods or use sparingly, unless you are having difficulty maintaining your weight. You can choose from:
• butter, margarine
• oils, sour cream
• peanut butter
• coconut cream.
Fats provide energy and vitamins A, D, E, and K. If you are trying to lose weight, eat less of these foods or choose lower fat versions; for example lite coconut milk.
Page 14
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Mōmona
Me iti ake te kai i ēnei momo kai me whakaomoomo rānei, atu i te tangata e noho tūpuhi ana. Pai noa iho te kōwhiri i te:
• pata, te margarine
• ngā hinu, te kirīmi kawa
• te pīnati pata
• te kirīmi kōkōnati.
Mā te mōmona ka whai kaha ka whai hoki i ngā huaora A, D, E, me te K. Mehemea kei te whakaheke koe i tō taumaha, kia iti ake te kai i ēnei kai, kia iti ake rānei te mōmona i roto i ngā kai, pērā ki te miraka kōkōnati lite.
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Page 15
Fluids (drinks)
Aim to drink eight glasses of water (1500ml) or other drinks each day (more if your cancer doctor recommends it). Limit alcohol, coffee, tea, and caffeinated drinks.
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Ngā momo wai
Me kaha to inu ia rā, ia rā, kia 8 ngā karāhe wai (1500ml), aha atu inu rānei (nui ake mēnā ka tohua e tō rata). Kia iti ake te inu kawhe, inu tī, me ngā inu caffeine.
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Page 16
Vitamins and minerals
These help your body use the food you eat. The best source of vitamins and minerals is food. If you follow the guidelines outlined here, it is unlikely that you will need vitamin and mineral pills unless you are found to be lacking in something.
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Ngā huaora me ngā manawa whenua
Ka āwhina ēnei i tō tinana ki te whakamahi i ngā kai ka kainga e koe. Ko te matamata pai mō ngā huaora me ngā manawa whenua, ko te kai. Ki te whai koe i ngā aratohu kua takoto i konei, e kore pea koe e hiahia i ngā pire huaora, manawa whenua hoki, inā rā, mei kore koe e mate i te hiahia mō tētahi mea.
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Some people believe that if a little bit of a nutrient is good for you, then a lot must be better. There is no scientific evidence to support this idea. High doses of some nutrients can have harmful effects and some vitamins, herbal supplements, and minerals should not be taken during treatment. Discuss with your cancer doctor or dietitian any vitamin and mineral supplements you are taking or think you should be taking.
Page 17
Food safety
Food safety is of special importance to cancer patients, especially during treatment that may suppress immune function. To make food as safe as possible it is recommended that patients follow the guidelines below:
• Wash hands thoroughly before eating.
• Keep all aspects of food preparation clean, including washing hands before preparing food, and washing fruit and vegetables.
• Handle raw meat, fish, poultry, and eggs with care, and clean thoroughly any utensils and surfaces that have been in contact with these foods. Keep raw meats separate from cooked food.
• Cook meat, poultry, and fish thoroughly, and use pasteurised milk and juices.
• Cover and refrigerate food promptly to minimise bacterial growth.
• When ‘eating out’, avoid foods that may have bacterial contamination, such as salad, sushi, and raw or undercooked meats, fish, poultry, and eggs.
• If there is any concern about the purity of your water, for example if you have well or tank water, have it checked for bacterial content and boil before use.
• To purify water, boil for at least a minute if you have any concerns.
Page 18
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Kai haumaru
He mea tino nui mō ngā tūroro matepukupuku te kai haumaru ā, ko te wā tino nui rawa atu, ko te wā o te maimoatanga, nā tōna kaha pēhi i te mahi whakaturi mate.
Kia noho haumaru ai ngā kai, me whai ngā tūroro i ēnei aratohu e whai ake nei:
• Āta horoia ō ringaringa i mua i te kaitanga.
• Kia mā tonu ngā mea katoa e pā ana ki te whakataka kai, tae noa ki te mahi horoi ringaringa i mua i ngā mahi whakataka kai, me te horoi huarākau, huawhenua hoki.
• Me tūpato i te wā mahi ai i te taha o ngā mīti, ngā heihei me ngā hēki, ā, me āta horoi hoki ngā wāhi i pā ngā kai nei. Me noho wehe ngā mīti mata i ngā kai māoa.
• Me tino māoa te tunu i ngā mīti, ngā ika me te whakamahi i te waiū pasteurised.
• Kia tere te uwhi i ngā kai ka rau ki roto i te whata mātao kia iti ake te tipu o te kitakita.
• I ngā wā puta ki ngā wharekai kai ai, me tūpato ki ngā kai ka pā te kitakita, pērā ki ngā wāhi kai huamata, ki ngā kai sushi me ngā kai mata pērā ki te mīti mata, te ika mata me te hēki mata.
• Mehemea he paku raru e pā ana ki te pai o te wai, pērā ki ngā wai i roto i te puna, i roto i te taika pupuri wai rānei, whakaritea kia tirohia te nui o te kitakita kei roto, ka pāera i te wai i mua i te whakamahia.
• Hei whakapai i te wai, me pāera mō te nui ake i te kotahi meneti, kia kore ai koe e māharahara.
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Page 19
Staying the same weight
Ideally, you should stay at the same weight you were before you had cancer, but you may find it difficult to maintain your weight during treatment. If you were a little overweight before you had cancer, you might think that it will not hurt to lose a few kilos. However, losing weight during treatment can be harmful. The effects of your cancer and of reduced activity may be that this weight is lost from muscles rather than from fat stores. If you maintain your weight, it can help you recover better from the effects of cancer and its treatment.
If you are losing weight, include frequent meals and snacks in your diet. Also include some of the high energy foods listed in the following pages.
You should talk to your nurse, cancer doctor, or radiation therapist if you are concerned about your weight: they can arrange an appointment with a dietitian.
Pages 20 - 21
Foods high in calories (energy) and protein
Use these foods when you are not eating well or you are losing weight.
Butter, margarine, oil, mayonnaise, dressings, avocado, coconut cream
Use with bread, rice, pasta, vegetables, when frying, in salads, dips, and in curries, or casseroles if you can tolerate these foods.
Milk, skim milk powder, cream, ice cream, evaporated or condensed milk, cheese, sour cream, cream cheese
Use in puddings, fruit, cereals, sauces, soups, in casseroles, on vegetables, in salads, on biscuits, and in drinks.
Box:
Double strength milk
Sprinkle three tablespoons of skim milk powder into 600ml (one pint) of milk and whisk until the powder is dissolved.
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One or more of the following can be blended into a glass of milk:
yoghurt, ice cream, skim milk powder, mashed/pureed fruit, powder/liquid flavourings, essences, cordial.
Nuts and dried fruit
Snack on these between meals or add to cereals, puddings, and salads.
Pages 22 - 23
See page 58 for our ready to go snack recipe.
Tofu
Add to soups, vegetables, and dried bean dishes.
Peanut butter, honey, jam, marmalade, golden syrup
Spread on bread, crackers, and baked products. Add to porridge or puddings.
Sugar
Add to drinks, desserts, and cereals. Use ordinary cordials and fizzy drinks rather than ‘diet’ or low calorie versions.
Eat cakes, biscuits, baked products, chocolate, and sweets between or after meals.
Pickles, chutneys, pate, hummus, and other dips
Add to crackers, bread, and in cooking.
Fluids
Choose fluids that provide energy; for example milky drinks, cordials, non-diet drinks, soups, and juices.
Page 24
Adding to what you can eat (nutritional supplement drinks)
These are not a meal replacement. They should be used in addition to meals and snacks when you need to gain weight, or if you are not eating normally. These provide all the major nutrients found in food, and vitamins and minerals.
Some brand name supplements are listed below. They are available from supermarkets and pharmacies. Those marked with an * can be obtained on prescription, but you will need to have a ‘special authority number’, which your cancer doctor can arrange. If you think you would benefit from these products, talk to your cancer doctor or nurse.
Powders that are mixed with milk or water
• Complan
• Vitaplan
• Sustagen classic.
These can be purchased from a supermarket. They do not meet all your nutritional needs.
• Ensure powder *
• Sustagen hospital formula. *
Page 25
Ready-made drinks (funded only for those having tube feeding)
• Ensure Plus *
• Fortisip *
• Fortisip Multi Fibre. *
These are lactose free, and provide all your nutritional needs if consumed in the right quantity.
Fortified fruit juice
These juices do not meet all your nutritional needs, but do supply additional calories, protein, and carbohydrates. These juices are not available on prescription.
• Enlive
• Fortijuce.
Page 26
Eating problems
If you are having or recovering from surgery or treatment, it is important to eat well. You may have some eating problems like a loss of appetite, nausea, taste and smell changes, and mouth or swallowing difficulties. Between your treatments, symptoms should improve, so take advantage of this and eat a variety of foods that you enjoy.
Tell your nurse, cancer doctor, or radiation therapist if you have not eaten well over the last few days.
Box:
Ngā raruraru e pā ana ki te kai
Mehemea e whai oranga ana koe i te wā o tētahi pokanga, tētahi maimoatanga rānei, he mea nui kia pai tō kai. Tērā pea ka whai atu ko tētahi mate e pā ana ki tō kaha ki te kai, pērā ki te kore hiahia ki te kai, te hia ruaki, te rerekē o te rongo i te kai, ki te horomi kai rānei. I ngā wā kāore koe i te whai i te maimoatanga, ko te tikanga ka pai ake koe, nā reira me kaha tonu tō kai i ngā momo kai pai katoa ki a koe. Mehemea ka hipa ngā rā me te kore pai o tō kai, me kōrero ki tō tapuhi, tō rata, tō kaituku iraruke.
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Listed on the following pages are some tips you may find helpful.
Page 27
Loss of appetite (not feeling hungry)
• Eat small, frequent meals and snacks rather than three big meals.
• Use a smaller plate and present meals attractively.
• Eat more at times you feel hungry.
• Serve your favourite foods often.
• If possible, eat with family or friends rather than by yourself, or try eating while watching TV or reading a magazine or newspaper to take your mind off the food.
• Choose fluids that provide calories rather than water, coffee, tea, or broth. Drink fluid after or in between meals, but not just before.
• Relaxing before meals can reduce anxiety.
• Try foods that are easy to eat; for example eggs, milk puddings, crackers, soups, spaghetti, macaroni cheese, chicken, fish, mashed vegetables, and fruit.
• Garnishing food with chopped herbs, watercress, onion rings, orange slices, nuts, or tomato wedges can make food more appealing.
• Chop food up into bite-sized portions to make eating less of an effort.
• Prepare enough for several servings when cooking so you can eat when you are hungry.
• Accept offers of meals from friends and family if you liv e on your own.
• Make use of ready-made foods.
• A short walk before a meal might make you feel hungry.
Page 28
Nausea (feeling sick)
• Not eating for an extended period of time can prolong nausea; therefore, try to eat small amounts regularly.
• Talk to your cancer doctor about anti-sickness drugs, and take them as directed.
• Keep up your fluid intake—sip drinks slowly or use a straw. Try ginger ale or lemonade, fruit juice, weak tea, yeast spreads made into broths, clear broths, fruit or vegetable juices, nectars, ice blocks, and ice chips.
• Eat your main meal at the time of day when you feel the best.
• Choose foods that do not have a strong smell.
• Try a short walk in the fresh air before eating or try some slow, deep breathing.
• Avoid fried, fatty foods, because they may make you feel worse.
• Dry foods such as toast or crackers might help (with drinks between meals).
• Rest after eating.
• Keep away from the kitchen if cooking smells put you off eating, or ask someone else to prepare your food.
• Generally, foods at room temperature have a mild smell compared with hot foods.
• Eat and drink slowly.
• Sit upright for meals and avoid tight clothing.
Page 29
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Te hia ruaki
• E kore koe e hia ruaki ki te kore koe e kai mō te wā roa nā reira, me auau te kai ahakoa paku noa iho.
• Kōrero ki tō rata mō ngā whakapōauau patu mate, me te whai i ngā tohutohu mō te kai.
• Kia kaha te inu—engari me āta inu, me whakamahi ngongo rānei. Whakamātauria te inu paitu kanekane, ngā inu waireka, tī ngoikore nei, ngā momo hupa, ngā wai o te huarākau me te huawhenua, ngā poraka aihikirīmi me ngā kotakota hukapapa.
• Kainga tō kai matua i te wā o te rā e tino pai ana tō āhua.
• Kōwhiria ngā kai kāore i kaha te haunga.
• Me paku hīkoi ki waho i mua i tō noho ki te kai, me whakahā pōturi me te hōhonu ake rānei.
• Me karo ngā kai parai me ngā kai mōmona, i te mea ka kino ake tō āhua.
• Tērā pea he pai te kai i ngā kai maroke pērā ki te tōhi, ki te pihikete pakapaka i waenganui i ngā kai nui (me te inu hoki).
• Me whakatā i muri te kai.
• Kaua e noho ki te kīhini mēnā he anuanu te kakara o ngā kai e tunu ana, me tono rānei i tētahi atu hei tunu i ō kai.
• Ko te tikanga, he iti ake te kakara o ngā kai mehemea kei te rite te pāmahana ki te rūma inā, ka whakaritea ki te kai wera.
• Me pōturi ake te kai i ō kai.
• Me tūtika te noho ki te kai, kaua e mau kākahu kikī rawa.
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Page 30
Taste and smell changes
Your treatment may cause your sense of taste or smell to change temporarily. You may not like foods which you once enjoyed, or find that you enjoy food which you previously disliked.
Here are some ideas that may help:
• Experiment with flavourings, such as lemon juice, herbs, chutneys and pickles, spices, pepper, celery salt, chocolate, fruit, or cheese.
• Add a little salt to foods that taste too sweet, and sugar to foods that are acidic (sour) or too salty.
• If you have lost your taste for meat, try marinating meats using soy sauce, honey, ginger, fruit juice, or wine before cooking. Or try canned or fresh fish, eggs, beans, nuts, lentils, or cheese instead.
• If your taste for salt is increased, eat small quantities of meats, such as corned beef, sausages, luncheon meat, bacon, ham, salty savouries, olives, anchovies, tinned or smoked fish, smoked chicken, tasty or feta cheese.
• Use fruit or fruit puree in ice cream or desserts, junket, milkshakes, or puddings to add extra flavour.
Page 31
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Ka rerekē tō rongo me tō hongi kai
Tērā pea ka rerekē tō rongo i te kakara o te kai i te wā o tō maimoatanga. Tērā pea, kāore koe e pīrangi ki ētahi kai e pai ana ki a koe i ngā rā ki mua, ā, kua hiahia hoki koe ki ngā kai kāore koe i pīrangi i ngā rā ki mua.
Anei he whakaaro tērā pea ka āwhina i a koe:
• Whakamātauria ngā pūkara, pērā ki te wai rēmana, ngā rauamiami, ngā chutneys, me ngā pīkara, ngā namunamuā, te pepa, te tote hārere, tiakarete, huarākau me te tīhi.
• Poua he tote ki te ngā kai mēnā he reka rawa, me te huka ki ngā kai kawa rawa, totetote rawa rānei.
• Mehemea kua ngaro tō hiahia kai mīti, whakamātauria te pūkarakara mīti mā te whakamahi i te wairanu soy, te mīere, te paitu kanekane, te wai huarākau, te waina i mua i te tunutanga rānei. Whakamātauria rānei te ika kua puototia, te ika mata, te hēki, ngā pīni, ngā nati, ngā lentils, te tīhi rānei.
• Mena kua piki tō hiahia mō te tote, kainga he paku mīti, pērā ki te mīti kau mina-tote, te tōtiti, mīti luncheon, pēkana, poaka tauraki, mākarakara totetote, he oriwa, he korowhāwhā, ika mina-auahi te ika puoto rānei, heihei mina-auahi, tīhi reka, tīhi feta rānei.
• Raua he huarākau ki roto i te aihikirīmi, te purini rānei, te junket, ngā milkshakes, hei whakapūkarakara.
End of Box
Pages 32 - 33
Mouth or swallowing problems
There may be times when eating is physically difficult. You may have difficulty chewing or moving food around your mouth, difficulties swallowing, or pain in your mouth or throat.
Here are some tips to help:
• Avoid foods that may sting your mouth, such as acidic or highly spiced foods; for example pineapple, kiwifruit, citrus fruits, tomatoes, spicy and salty foods, very hot or icy cold foods and drinks.
• Avoid rough and crunchy foods, such as nuts, chips, and hard toast.
• Add dressings and sauces to make food moist.
• Try drinking liquids through a straw.
• Cook meat until very tender so you do not have to chew so much.
• It is important to keep your mouth clean to prevent infection and dental decay. It will help to clean your teeth with a soft toothbrush, and use a mouthwash after each meal. Check dentures are well-fitting. Ensure dentures are sterilised regularly to avoid infection.
Page 34
Box:
Mouthwash recipe
1 teaspoon salt
1 teaspoon baking soda
4 cups water
Add lemon juice for flavour if desired (although this may sting if your mouth is tender and sore).
End of Box
If your mouth is too sore to eat adequately, pain relievers may help. Ask your cancer doctor or nurse for their advice.
Dry mouth
• Serve drinks with meals. Sip when eating.
• Suck on ice blocks to provide moisture. Ice blocks will also help you to make saliva.
• Tart foods and drinks may also encourage the flow of saliva.
• Try pineapple juice or lemon juice in ice blocks for a refreshing mouthwash.
• Avoid dry foods. Add gravy, sauce, custard, cream, milk, melted butter, oil, or dressing to make food moist.
Lemon juice is highly acidic and long-term use can lead to tooth decay.
Page 35
Box:
“I have found that the dry mouth that followed radiation treatment on my tongue had two quite separate effects.
The most obvious one is that I have less saliva. This is very easily addressed by sipping drinks while eating. The second, though, is less well understood. My saliva is now less able to disperse the fibres that are being chewed. This means that some food tends to wad in my mouth and is difficult to swallow. Sipping a drink helps a bit but the real gains come from including a natural ‘saliva substitute’, such as white sauce or mashed potato.
The foods that are most prone to wadding are salad greens, boiled rice, instant pasta, chicken breast, steak (unless very tender), and firm-fleshed fish. I love all of these but have difficulty eating them by themselves. I find it easiest to do so if they are served with potato or a white (flour-based) sauce.
Other tips
When the rice is prepared as risotto or a creamed rice dessert, its consistency is changed and there is no problem.
Instant pasta, such as spaghetti or lasagne is fine if they are part of a dish that has a sauce.
Cook a chicken breast in a way that retains its moisture and serve with potatoes or a white sauce.”
Brian
End of Box
Page 36
Making food easier to eat
Changing the texture of foods can make it easier to chew and swallow.
Soft foods
These are foods that are soft enough so that they can be cut with the side of a fork. Vegetables may need to be cooked for longer, and meat or chicken cooked longer on a lower heat with liquid to make them soft and tender.
Here are some soft food suggestions.
Soups
• Smooth with no hard lumps.
Eggs
• Scrambled, poached, boiled, or made into an omelette.
• Quiche or soufflé.
• Cooked sliced egg in a cheese sauce, or mild curry sauce with rice.
Milk and milk products
• Dairy food, yoghurt, ice cream, milk puddings, soft cheeses, and cheese sauce.
• Avoid hard cheeses or those with dried fruit or nuts in them.
• Avoid grilled cheese that has gone hard.
Page 37
Fish
• Fish in white sauce/ cheese sauce/ parsley sauce.
• Convenience foods—boil in the bag, fish fingers, fish nuggets, canned tuna/ smoked fish/ salmon.
Chicken
• Boiled/ steamed/ microwaved/ roasted, or rotisserie, and diced with gravy, white sauce, mushroom sauce, cheese sauce, other sauces, or mashed potato.
Meat
• Boiled, stewed, roasted, grilled, and diced or sliced, served with gravy, mint sauce, redcurrant jelly, mustard sauce, other sauces, or mashed potato.
• Cold meats—ham, pork and apple sauce, ham and chicken.
• Mince with spaghetti, meat balls, potato top pie, and hamburger patties.
See page 60 for our mince pasta dish recipe.
Breads and cereals
• Soft breads without crusts with soft fillings; for example ham, egg and grated cheese and pineapple, minced chicken and mayonnaise, canned fish, and smooth peanut butter, or asparagus.
Pages 38 - 39
Fruit and vegetables
• Fresh, stewed, or canned fruit and vegetables.
• Soften by chopping, mashing, or grating.
Snacks
• Baking—biscuits or cakes; for example shortbread, sponge or Madeira cake, fruit loaf, muffins, pikelets, scones, and crackers.
Pureed foods (food with no lumps)
Use a blender, stick blender, or food processor to puree foods so that they have a smooth texture with no lumps.
Method
• Food processor—if you do not have a blender, stick blender, or food processor, a mouille and strainer can produce similar results, but it will take more time.
• Add liquid (ideally, use a nutritious liquid; for example gravy, full fat milk, white sauce, soup, cream sauce, or fruit juice rather than water). Continue adding more liquid until the desired consistency is reached.
• Blend until the mixture is smooth with no lumps.
Pages 40 - 41
Tips
• Some fibrous fruit and vegetables (for example peas, corn, celery, onions, and pip fruits) may not puree very easily. Try straining after pureeing and they may be soft enough.
• Individual flavours and colours of a meal can be preserved better when vegetables and meat are pureed separately.
• Pureed meat often loses its colour and flavour—try adding tomato, soya, or Worcestershire sauce, herbs, mushrooms, or tomatoes. Serve meats with gravies, sauces, or jellies; for example mint sauce or redcurrant jelly with lamb. Pureed meals can be frozen. Thaw in the fridge and heat thoroughly, add a little more liquid if necessary. If stored in the refrigerator, pureed meals will keep for only 12 hours.
• Green vegetables can look unappealing when pureed. Try mixing with a little mashed potato or instant potato flakes. Tasty pureed vegetable combinations include swede and carrot, carrot and parsnip, and beans and parsnip.
Page 42
Bowel problems
Treatment can alter your normal bowel habit causing constipation or diarrhoea. Consult your cancer doctor if symptoms persist. (These recommendations need to be adjusted for people with some types of cancer; for example bowel cancer.)
Constipation (hard bowel motions)
If you are constipated, increasing the fibre content of your diet can help:
• Eat regular meals.
• Do some exercise each day.
• Increase the amount you drink. Aim for 8 to 10 glasses each day. Hot drinks may help.
• Ensure you are having 5+ servings of fruit and vegetables each day. Eat raw or cooked.
• If too much wind is a problem, try avoiding vegetables that may cause wind or discomfort, such as cabbage, onions, cucumber, peas, and baked beans, and limit fizzy drinks.
• Choose wholemeal or wholegrain breads and cereals; for example porridge, Weetbix, All Bran, muesli, wholemeal bread, wheat germ, bran biscuits, or muffins. Use wholemeal flour for baking or in sauces.
See page 63 for our fruit kebabs with yoghurt and honey dipping sauce recipe.
Page 43
• Commercial products, such as Kiwicrush, Benefiber, Metamucil, or Stimulance may be useful.
• Kiwifruit, prunes, and their juices are helpful in preventing constipation.
• Add extra fibre to your food; for example one or two teaspoons of wheat bran flakes or oat bran daily. This can be gradually increased to an amount that will give you a regular bowel habit. The bran can be added to cereals or used in cooking. When you use bran to increase your fibre it is important to increase your fluids as well.
Prune mix
Try some of this prune mix daily.
Ingredients:
1 cup pureed apple
1 cup bran flakes
½ cup softened prunes
1 cup prune juice
Directions:
Puree together using a blender, stick blender, or food processor, and serve two to three tablespoons with breakfast daily.
Page 44
Diarrhoea (loose bowel motions)
Some chemotherapy drugs cause severe diarrhoea. If you have diarrhoea, contact your cancer doctor or nurse immediately. Following an acute bout, gradually start eating bananas, rice, apples, and toast.
• Drink more to replace lost fluids. Choose from diluted fruit juice, flat soft drink, vegetable juice, vegetable broth, weak tea, and nutritional supplements. Aim to drink at least eight glasses (1500ml) of fluid daily.
• Eat small, frequent meals.
Box:
Kōrere (mate tikotiko)
Ka puta te mate kōrere kino rawa atu nā ētahi o ngā whakapōauau hahau. Ki te pāngia koe ki te mate kōrere, me kakama tonu te whakapā atu ki tō rata matepukupuku, tō tapuhi matepukupuku rānei. Whai muri i te mate tikotiko me tīmata ki te kai panana, raihi, āporo me te tōhi.
• Kia kaha te inu hei whakahoki i te wai kua ngaro. Me kōwhiri mai i te wai huarākau kua waimehatia, te inu waireka kore mirumiru, inu huawhenua, wairenga huawhenua, tī ngoikore me ngā tāpiringa kai tōtika. Me whai kia 8 ngā karāhe inu (1500ml) i ia rā ia rā.
• Kia iti te kai engari kia maha tonu ngā wā kai.
End of Box
Page 45
What is a low fibre diet?
Your dietitian or cancer doctor may advise you to eat a low fibre diet. A low fibre diet is when you have less of or none of these foods:
Breads and cereals
Breads that contain whole grains, nuts, seeds, and kibbled wheat; cereals, such as muesli, which contain nuts, seeds, or dried fruit; and brown rice or pasta.
Fruit
Fruits with seeds, pips, pith, or hard skins; for example kiwifruit, berries, apples, citrus fruits, and dried fruit.
Vegetables
Vegetables with hard skins, seeds, or stalks; for example corn, celery, vegetables from the cabbage family, onions, cucumbers, garlic, peas, and broad beans.
Nuts and seeds
Crunchy peanut butter, nuts, and seeds—whole or chopped.
Meat, fish, poultry, eggs, and pulses
Tough, gristly meat, fried meat, fish, or poultry, fatty or highly seasoned meats, such as sausages, curry, prepared dried meals, fried eggs, baked beans, and pulses.
Page 46
Other foods or drink that may make diarrhoea worse:
Drinks
Alcoholic drinks, strong tea, or coffee.
Fat
Rich sauces, highly seasoned dressings, rich pastry, batter, and fried foods. Any new foods should be introduced one at a time, so that you can check their effect. You can gradually return to a normal diet.
If you have severe diarrhoea, see your cancer doctor. A low residue diet may be recommended.
Box:
Mōmona
Ko ngā wairanu mōmona, ngā wairanu huamata, ngā pōhā mōmona, te kaihau me ngā kai parai. Me āta kai i ngā kai hōu, kia paku noa iho i ia wā kia pai ai tō whakamātau i tōna pānga. A tōna wā ka hoki ki tōu ake kaha ki te kai.
Ki te kaha pāngia koe ki te mate tikotiko, haere ki te kite i tō rata. Tērā pea, ka taunakitia tētahi nohopuku iti ake te paranui.
End of Box
Page 47
Eating a low residue diet
This is the same as a low fibre diet plus the points below:
• If you experience cramping pains, bloating, and diarrhoea (these can result if lactose (milk sugar) is not digested), you could try limiting the amount of cow’s milk you drink to 300ml daily. Hard cheeses are usually well-tolerated. Cow’s milk should be replaced with soy or rice milk, or nutritional supplement drinks. You will be able to tolerate lactose again after the diarrhoea has settled. Cow’s milk may then be re-introduced. Many people do tolerate milk products, and they should only be avoided if not tolerated on a regular basis.
• It is wise to limit fruit and vegetables to three servings a day. All fruit and vegetables should be peeled and cooked without pips or seeds. You do not need to limit the fruit and vegetable juices you drink.
• Use white bread for toast and sandwiches. Use cream crackers and water crackers for snacks. Only use baked or cereal products made from white flour; for example white rice, noodles, spaghetti, cornflakes, and rice bubbles. Avoid pepper, curries, foods containing spices, alcohol, and fatty foods.
• Re-introduce foods one at a time so that you can judge their effect.
Page 48
Intolerance to some foods (food that makes you feel unwell)
If you have had bowel surgery, you may find for a time that your body can no longer tolerate some foods that were a part of your diet. It will take time for your body to adjust to the changes made by the surgery but, usually, it will slowly return to a normal or near normal state. After a time (it may take some weeks or months), slowly introduce a new food into your diet. Try one new food at a meal, and start with a teaspoonful. Once you find that your body accepts the new food, you can increase the quantity. You will then be able to do the same for another new food.
Fatigue
You may experience extreme tiredness (fatigue) during or after surgery/treatment:
• Eat small frequent meals.
• Have a variety of foods to keep meals interesting and appetising.
• Remove rules around eating.
• You may find nutritional supplements useful (see page 24 for more information).
Use ready prepared foods, have two to three pre-prepared meals in the freezer for treatment days or days that you have a lot of appointments.
For more information on managing your fatigue, read our Information Sheet “Cancer-Related Fatigue” on the Society’s website (www.cancernz.org.nz).
Page 49
Easy ways to make meals
• Prepare and freeze extra meals when you are feeling better to save time and effort when you are not feeling so well.
• Keep stocks of convenience foods—‘ready to prepare’ noodle or rice dishes, spaghetti, baked beans, canned fish, packet or canned soups, instant gravy or sauce sachets, eggs, cheese, milk, canned or packet dessert foods.
• Use the freezer to store bread, pizza, pies, fish, meat and chicken portions, frozen vegetables, and individual meals.
• Use the microwave oven to cook vegetables quickly, and to reheat leftovers and frozen convenience foods.
Keep stocks of nutritious fluids, such as nutritional supplement drinks, fruit juice, and milk.
Pages 50 - 51
Recipes
Fruit smoothie
Have your favourite fruit and increase your bone health at the same time. Experiment with your favourite fruit to create your ultimate quick and easy snack.
Ingredients:
1 pottle low fat berry yoghurt
1 banana
1 cup trim milk
1 drop of coconut essence
1 teaspoon flavoured milkshake mix
Directions:
Place all of the ingredients in a blender. Blend until smooth.
Serve in a tall glass with a straw and, if desired, garnish with a sprig of mint.
Cook’s tip:
Add your favourite fruit into the mixture to suit your taste buds.
If you choose not to have cow’s milk products, calcium fortified soy or rice products should be included as substitutes.
Page 52
Quick and easy wraps
Wraps are so versatile and easy, perfect as a snack, or a meal on the run.
Ingredients:
1 packet of wholemeal tortilla or naan bread (wraps)
1 Tablespoon oil
1 onion, sliced
400g pork, cut into bite-sized pieces
1 Tablespoon soy sauce
2 carrots, grated
2 cups cabbage, shredded
⅓ cup red capsicum, diced
⅓ cup green capsicum, diced
½ cup Edam cheese, grated
2 Tablespoon balsamic vinegar
100g hummus
2 Tablespoons sweet chilli sauce (optional)
Directions:
Place the vegetables and cheese in a large bowl. Mix well. Toss in the balsamic vinegar and set aside.
Heat the oil in a fry pan on a medium heat. Brown the onion and then add in the pork. Add in the soy sauce and stir regularly. Cook the pork until the meat is browned. The inside of the meat should be white right through, and the juices run clear.
Place the wrap on a plate and heat in the microwave for 10 seconds. Spread a teaspoon of the hummus and chilli sauce onto the centre of the wrap. Place a small portion of the pork and vegetables in the middle of each wrap, fold in the edges, and roll up.
Page 53
Cook’s tip:
There is an endless list of fillings you can put into a wrap. Try adding stir-fries, falafel, refried beans, other cuts of meat, salads, and rice. This way, each wrap will be slightly different each time.
Page 54
Roast vegetable medley
Jazz up your roast vegetables by adding a variety of different vegetables, adding colour, flavour, and a boost of anti-oxidants.
Ingredients:
4 small-medium sized potatoes (skin on and scrubbed with a scourer to remove dirt)
1 kumara (skin on and scrubbed)
¼ pumpkin
2 carrots
1 parsnip
1 celery stick
2 courgettes
1 bulb of garlic
Favourite herbs (optional)
Iodised salt and pepper to taste
2 Tablespoon oil
Directions:
Preheat oven to 220°C.
Chop the vegetables into manageable sized chunks. Try to keep all of the vegetables around the same size for even cooking with the exception of the carrots and celery which can be bigger.
Arrange all of the vegetables except the celery in a large roasting dish. Do not put the vegetables in the same dish with any roast meats. Pour over oil and toss to cover all of the vegetables. Season with salt, pepper, and herbs to taste.
Page 55
Bake for 30 minutes before adding the celery and bake for a further 20 minutes or until golden and soft. Remove from the oven and allow to cool for 5 minutes. Serve with roast meats, fresh steamed green vegetables, and gravy.
Cook’s tip:
Cook the vegetables in their own dish.
Pages 56 - 57
Waldorf salad with a difference
This is a healthier option to the classic waldorf salad which has a high energy, creamy mayonnaise. This version is better for you, and still full of flavour.
Ingredients:
2 apples, chopped and left unpeeled
1 lemon, juiced
5 celery sticks, roughly chopped
1 carrot, chopped
1 cup grapes
100g feta cheese, cubed
Salt and pepper to taste
¼ cup vinaigrette or balsamic vinegar
½ cup parsley leaves (optional)
½ cup pumpkin and sunflower seeds (optional)
¾ cup walnuts, roughly chopped
Directions:
Place the apples in a large mixing bowl and toss through the lemon juice. Then add the other ingredients.
Place in the fridge or serve immediately as a side or a light main dish. Garnish with pumpkin and sunflower seeds.
Cook’s tip:
Don’t forget to put the lemon juice on the apples or they will turn brown.
Page 58
Ready to go snack
Jam-packed with energy, this snack is super easy to make and perfect for school lunches or a snack on the go.
Ingredients:
1 cup mixed, dried nuts
2 cups mixed, dried fruit
½ cup pumpkin seeds
½ cup sunflower seeds
½ cup chocolate buttons, roughly chopped
¼ cup shredded coconut
Directions:
Mix all of the ingredients in a large resealable bag or airtight container.
This can be portioned out into smaller containers or bags for midday snacks or served in a bowl for guests.
Cook’s tip:
Keep your portions to a minimum. Dried fruit can be deceiving. Remember that fresh fruit shrinks a lot as it dries so a small handful of dried fruit contains the same energy as the full-sized fresh fruit. Nuts and seeds also contain a lot of energy.
Page 60
Mince pasta dish
This one-pot-wonder is a great way of preparing a nutritious meal. It’s also a great comfort food with leftovers to freeze for another night.
Ingredients:
1 Tablespoon oil
2 onions, chopped
3 garlic cloves, minced
3 celery sticks, chopped
1kg minced beef
100g tomato paste
3 cups beef stock
3 carrots, sliced
2 cups broccoli florets
¾ cup corn kernels—fresh, frozen, or canned
2 cups pasta shells
1 teaspoon basil
¾ cup red capsicum, chopped
¾ cup green capsicum, chopped
Iodised salt and pepper to taste
2 teaspoon cornflour (optional)
Parsley and grated Parmesan or Edam cheese garnish (optional)
Directions:
Heat the oil in a large saucepan on a medium to high heat. Brown the onions, and then the mince before adding in all of the other ingredients, with the exception of the capsicums and mix well.
Simmer the ingredients for 10 minutes before adding in the capsicums. Cook for a further 5–10 minutes or until the pasta is al dente (almost soft) and the vegetables are soft.
Page 61
Add more water if needed. You want enough fluid to just cover the ingredients, allowing the pasta and vegetables to simmer and prevent the ingredients sticking to the bottom of the saucepan. If the mixture becomes too watery, combine cornflour and a small amount of cold water and add into the mince mixture.
Mix well.
Serve with grated Edam or Parmesan cheese and fresh parsley.
Cook’s tip:
Use different vegetables depending on the season, such as leeks in winter, and courgettes in summer, or add frozen mixed vegetables.
Pages 62 - 63
Fruit kebabs with yoghurt and honey dipping sauce
Fruit kebabs are a simple but effective way to make fruit look appealing. Encourage your kids to help make them— they’re easy.
Ingredients:
1 cup plain yoghurt 2 Tablespoon honey
Use your favourite fresh fruit
1 red apple, diced (core removed, skin on)
1 banana, chopped into 2cm thick chunks
10 grapes
2 mandarins, broken into segments
3 kiwifruit, cut into chunks
1 Tablespoon lemon juice
6 bamboo skewers
¼ cup favourite unsalted, unroasted nuts (optional)
Sprig of mint, garnish
Summer suggestions: strawberries, melons, apples, kiwifruit, peaches, oranges, cherries.
Winter suggestions: apples, bananas, pears, mandarins, kiwifruit, grapes, persimmons.
Directions:
Place the honey in a heatproof cup and heat in the microwave for 30 seconds, or until it has become runny. Allow to cool for a minute, before mixing the honey into the yoghurt.
Page 64
Cut the fruit into chunks. Place apple and banana in a plastic bag. Pour in the lemon juice. Mix the ingredients in the bag to coat the fruit with lemon juice to prevent it from browning.
Thread the fruit and nuts onto the skewers, alternating between the different types of fruit making a colourful pattern.
Serve with the yoghurt dipping sauce, or pour the yoghurt mix over the kebabs and add the mint to garnish.
Cook’s tip:
For the best effect, these will need to be prepared right before serving. Make up a huge platter of fruits and vegetables and encourage everyone to make their own with their favourite fruits.
Page 65
Suggested reading and websites
Reading
Beliveau, Richard and Gingras, Denis. (2007) Foods to Fight Cancer. Australia: DK Publishing.
Besser, Jeanne et al. (2009) What to Eat During Cancer Treatment. Atlanta: American Cancer Society.
Buckman Weinstein, Jodi. (2010) Tell Me What to Eat Before, During and After Cancer Treatment. USA: New Page Books.
Clegg, Holly and Miletello, Gerald. (2006) Eating Well Through Cancer. USA: Favorite Recipes Press.
Gourley, Glenda. (2010) The New Zealand Vegetable Book. New Zealand: Hyndman Publishing. (There’s also a good website (www.vegetables.co.nz).)
Grant, Barbara, L. et al. (2010) American Cancer Society Complete Guide to Nutrition for Cancer Survivors (2nd ed.). Atlanta: American Cancer Society.
Katzin, Carolyn. (2011) The Cancer Nutrition Center Handbook—An Essential Guide for Cancer Patients and Their Families. Los Angeles: CFK.
van Mil, José. (2008) Healthy Eating During Chemotherapy. USA: Kyle Books.
For more suggestions, visit your Cancer Society’s library or local library.
Page 66
Websites
American Institute of Cancer Research www.aicr.org/patients-survivors/
New Zealand Food Safety Authority Food Safety: When you have low immunity http://www.foodsmart.govt.nz/elibrary/lowimmunity.pdf
The suggested websites (other than our own) are not maintained by the Cancer Society of New Zealand. We only suggest sites we believe offer credible and responsible information, but we cannot guarantee that the information on such websites is correct, up-to-date, or evidence-based medical information. We suggest you discuss any information you find with your cancer care health professionals.
Pages 67 - 68
Notes
You may wish to use this space to write down any questions for or advice given by your cancer doctors, nurses, or health providers at your next appointment.
Box:
Whakamahia tēnei wāhi wātea hei tuhi pātai e hiahia ana koe ki te pātai i tō rata, ngā tapuhi, ngā kaiwhakarato hauora rānei mō te wā e hoki atu ai koe.
End of Box
Page 69
Cancer Society of New Zealand Inc.
National Office
PO Box 12700, Wellington 6144
Telephone: (04) 494-7270
Auckland Division
PO Box 1724, Auckland 1140
Telephone: (09) 308-0160
Covering: Northland
Waikato/Bay of Plenty Division
PO Box 134, Hamilton 3240
Telephone: (07) 838-2027
Covering: Tauranga, Rotorua, Taupo, Thames, and Waikato
Central Districts Division
PO Box 5096, Palmerston North 4441
Telephone: (06) 364-8989
Covering: Taranaki, Wanganui, Manawatu, Hawke’s Bay, and Gisborne/East Coast
Wellington Division
52 Riddiford Street, Wellington 6021
Telephone: (04) 389-8421
Covering: Marlborough, Nelson, Wairarapa, and Wellington
Page 70
Canterbury/West Coast Division
PO Box 13450, Christchurch 8141
Telephone: (03) 379-5835
Covering: South Canterbury, West Coast, and Ashburton
Otago/Southland Division
PO Box 6258, Dunedin 9059
Telephone: (03) 477-7447
Covering: Urban and rural Otago and Southland
Cancer Information Service
Telephone: 0800 CANCER (226 237)
www.cancernz.org.nz
Page 71
Feedback
Eating well during cancer treatment / Kia pai te kai i te wā maimoatanga matepukupuku
We would like to read what you thought of this booklet, whether you found it helpful or not. If you would like to give us your feedback, please fill out this questionnaire, cut it out, and send it to the Information Manager at the address at the bottom of the following page.
Transcriber's Note: where tick boxes are given in this form there will be the text "Tick Box". Where space is left for you to fill out a comment there will be the text "Enter Text". End of Note.
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Page 72
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Page 73
Information, support, and research
The Cancer Society of New Zealand offers information and support services to people with cancer and their families/whānau. Printed materials are available on specific cancers and treatments.
Information for living with cancer is also available.
The Cancer Society is a major funder of cancer research in New Zealand. The aim of research is to determine the causes, prevention, and effective methods of treating various types of cancer.
The Society also undertakes health promotion through programmes such as those encouraging SunSmart behaviour, eating well, being physically active, and discouraging smoking.
We appreciate your support
The Cancer Society receives no direct financial support from Government so funding comes only from donations, legacies, and bequests. You can make a donation by phoning 0900 31 111, through our website, or by contacting your local Cancer Society.
Acknowledgements
The Cancer Society would like to thank for their reviews, advice, and contributions:
Kathy Hamilton
Dietitian, Oamaru Hospital, Waitaki District Health Service and Otago HEHA Manager, Southern DHB
Helen Brown
Dietitian, Nurse Maude, Christchurch
Professor Lynette Ferguson
Auckland Cancer Society Research Centre, School of Medical Sciences, Head of Department of Nutrition, School of Medical Sciences, The University of Auckland
Dr Jan Pearson
National Health Promotion Manager, National Office, Cancer Society of New Zealand
Meg Biggs, Julie Holt, and Michelle Gundersen-Reid
Cancer Society Information Nurses
Associate Professor Chris Atkinson
Medical Director of the Cancer Society of New Zealand and Oncologist at St George’s Cancer Care Centre
Sarah Stacy-Baynes
National Information Manager
We thank the people who have experienced cancer who reviewed this edition, and offered many valuable suggestions. We also thank the Cancer Society volunteers who agreed to be photographed for our booklet.
Photography
This cover photo was taken by Moxie Communications.
Back Page
www.cancernz.org.nz
Any cancer, Any question
0800 CANCER (226 237)
Cancer Information Helpline
End of Eating well during Cancer Treatment
Living with Cancer
Eating well during cancer treatment - Kia pai te kai i te wā maimoatanga matepukupuku
A guide for eating well during treatment
Adapted in accordance with Section 69 of the Copyright Act 1994 by the Royal New Zealand Foundation of the Blind, for the sole use of persons who have a print disability.
Produced 2012 by Accessible Format Production, RNZFB, Auckland
This edition is a transcription of the following print edition:
Published by The Cancer Society
Copyright 2012 Cancer Society of New Zealand Inc,
PO Box 12700, Wellington.
Fifth Edition 2007 ISBN 0-908933-70-3
Sixth Edition 2012 ISBN 0-908933-92-4
Omissions
All images are omitted from this copy of Living with Cancer: Eating well during cancer treatement – Kia pai te kai I te wā maimoatanga matepukupuku.
Publications Statement
The Cancer Society’s aim is to provide easy-to-understand and accurate information on cancer, its treatments, and the support available.
Our Living with Cancer information booklets are reviewed every four years by cancer doctors, specialist nurses, and other relevant health professionals to ensure the information is reliable, evidence-based, and up-to-date. The booklets are also reviewed by consumers to ensure they meet the needs of people with cancer.
Other titles from the Cancer Society of New Zealand / Te Kāhui Matepukupuku o Aotearoa Booklets
Advanced Cancer/Matepukupuku Maukaha
Bowel Cancer/Matepukupuku Puku Hamuti
Bowel Cancer and Bowel Function: Practical advice
Breast Cancer/Te Matepukupuku o nga-Ū
Breast Cancer in Men: From one man to another
Cancer Clinical Trials
Cancer in the Family: Talking to your children
Chemotherapy/Hahau
Complementary and Alternative Medicine
Eating Well During Cancer Treatment
Emotions and Cancer
Got Water?/He Wai?
Lung Cancer/Matepukupuku Pūkahukahu
Melanoma/Tonapuku
Prostate Cancer/Matepukupuku Repeure
Radiation Treatment/Haumanu Iraruke
Secondary Breast Cancer/Matepukupuku Tuarua ā-Ū
Sexuality and Cancer/Hōkakatanga me te Matepukupuku
Understanding Grief/Te Mate Pāmamae
Brochures
Being Active When You Have Cancer
Being Breast Aware
Bowel Cancer Awareness
Gynaecological Cancers
Questions You May Wish to Ask
Talking to a Friend with Cancer
Thermography
This edition of Eating Well During Cancer Treatment/ Kia Pai te Kai i te Wā Maimoatanga Matepukupuku includes a new feature in response to suggestions from those who review our booklets, and to meet the needs of our readers. Our key messages and important sections have been translated into te Reo Māori. Our translations have been provided by Hohepa MacDougall, of Wharetuna Māori Consultancy Services and have been peer reviewed by his colleagues.
Page 1
Eating well during cancer treatment
This booklet has been prepared to help you with questions you may have about your diet while undergoing cancer treatment. It will help you to deal with any eating problems caused by your cancer or by your treatment.
You might like to pass this booklet on to your family/whānau and friends.
Box:
Kia pai te kai i te wā maimoatanga matepukupuku
I whakaritea te pukapuka nei hei āwhina i a koe ki te whakautu i ngā pātai tērā pea ka ara ake e pā ana ki tō nohopuku i te wā e whakamahia ana ngā maimoatanga matepukupuku. Ka āwhina hoki i a koe e whaihanga ana i ngā raruraru ka ara ake nā tō mate, nā tō maimoatanga rānei.
Tērā pea ka pīrangi koe ki te hoatu i te pukapuka nei ki tō whānau, ki ō hoa rānei.
End of Box
Page 2
Contents
Eating well, feeling better – Page 3
What is a healthy diet? – Page 5
Food safety – Page 17
Staying the same weight – Page 19
Foods high in calories (energy) and protein – Page 20
Adding to what you can eat (nutritional supplement drinks) - Page 24
Eating problems – Page 26
Loss of appetite (not feeling hungry) – Page 27
Nausea (feeling sick) – Page 28
Taste and smell changes – Page 30
Mouth or swallowing problems – Page 32
Dry mouth – Page 34
Making food easier to eat – Page 36
Soft foods – Page 36
Pureed foods (food with no lumps) – Page 38
Bowel problems – Page 42
Constipation (hard bowel motions) – Page 42
Diarrhoea (loose bowel motions) – Page 44
What is a low fibre diet? – Page 45
Eating a low residue diet – Page 47
Intolerance to some foods (food that makes you feel unwell) – Page 48
Fatigue – Page 48
Easy ways to make meals – Page 49
Recipes – Page 50
Suggested reading and websites – Page 65
Notes – Page 67
Feedback – Page 71
Page 3
Eating well, feeling better
Eating good food is important when you are well, and it is also very important when you are receiving treatment for cancer.
It is important that you eat well so that you will:
• feel better and have more energy
• get the most benefit from your treatment with fewer side effects
• improve your body’s ability to heal, and to fight infection
• maintain a healthy weight.
If you are thinking about making a dramatic change to your diet, look at your choices closely and discuss them with your cancer doctor or dietitian.
Once a cancer has developed it cannot be cured through diet alone. Many unproven dietary treatments, particularly those that cut out whole food groups, such as meat or dairy, may not provide enough energy (calories or kilojoules), protein, or essential nutrients. This can cause unwanted weight loss, tiredness, and decrease your immune function. Your recovery and quality of life can improve if you eat a healthy diet.
There is no evidence to support claims that special diets or single nutrients, such as a particular vitamin, can cure cancer. Some diets or nutrients do no harm, but there are some that are harmful and can interfere with the success of your treatment.
Page 4
Box:
Kia pai te kai, kia ora ake ai
He mea nui te kai i ngā kai pai i a koe e noho ora ana, ā, he pērā anō hoki i te wā e whai maimoatanga ana koe mō te matepukupuku.
He mea nui rawa atu kei te kai pai koe:
• kia piki te ora ki a koe, kia whai kaha hoki
• kia puta ngā painga o tō maimoatanga, me te iti ake o ngā pānga kino
• kia pai ake tō tinana ki ngā mahi whakaora, me te patu i te mate urutā
• kia noho hauora ai te taumaha o tō tinana.
Mehemea kei te whakaaro koe ki te tino whakarerekē i tō nohopuku, āta tirohia ō kōwhiringa ka korero ki tō rata ki tō mātanga nohopuku rānei.
Ka pā ana te matepukupuku, ehara i te mea ka ora te tangata mā te kai pai anake. He nui ngā maimoatanga nohopuku korehua, kāre e pai mō te whakarato pūngao, (pūngoi, he kilojoules rānei), pūmua me ngā whakamōmona tino matua, tae noa ki ngā nohopuku whakakore i te katoa o tētahi momo kai, pērā ki te whakakore i te kai mīti, i ngā kai ahu mai i te miraka. Mā tēnei, tērā pea ka heke rawa te taumaha o te tangata, ka tere māuiuitia rānei me te heke iho o te mahi whakatō ārai mate.
Ka pai ake tō whakamāui me tō oranga mehemea ka whai koe i tētahi nohopuku hauora. Kāore he kōrero pono hei tautoko i taua whakaaro, ka ora ake te tangata i te matepukupuku mā te kai motuhake, mā tētahi momo whakamōmona rānei pērā i tētahi hauora hāngai.
Page 5
Ehara i te mea he kino ētahi o ngā kai nohopuku motuhake ngā whakamōmona rānei, heoi, arā etahi momo kāore i te pai ā, tērā pea ka whakararu i tō maimoatanga.
End of Box
What is a healthy diet?
Choosing a wide variety of healthy foods is something very positive that you can do to help you feel stronger and maintain a healthy weight.
You can check how you are doing by following these guidelines, which will provide all the nutrients you need. If what you usually eat includes foods that are not listed, talk to your treatment team.
Box:
He aha hoki te kai tōtika?
Ko te kai i te maha o ngā momo kai huaora tētahi mea pai hei āwhina i a koe kia pakari ake, ā, kia pai hoki te haere o tō taumahatanga.
End of Box
Every day you need: Ia rā, ia rā me whai koe i ēnei:
Calories (energy) / Ngā pūngoi (pūngao)
Calories provide fuel for your body to do daily activities and maintain body weight.
Pages 6 - 7
Calories (energy) are provided by: Protein / Pūmua
Protein maintains and renews your body tissues and helps your body defend itself against infection.
The American Institute of Cancer Research also has recommendations on healthy eating. To view these recommendation, visit the Institute’s website:
http://www.aicr.org/new-american-plate/
Sources of protein are: Ahu mai ai te pūmua i:
Milk and milk products: Te waiū me ngā hua waiū
Have at least two servings of milk or milk products a day.
One serving is:
• a glass of milk
• or two slices of cheese
• or a pottle of yoghurt or dairy food.
You can also choose cottage cheese, soft cheeses, ice cream, or milk puddings. Milk and milk products are a valuable source of calcium for bone health.
See page 50 for our fruit smoothie recipe.
Page 8
Meats, poultry, fish, eggs (animal protein) - Mīti, heihei, ika, hēki (pūmua kararehe)
Have at least one serving a day. Choose meat, chicken, fish (a serving size is equal to the size of your palm or two cooked eggs, or two drumsticks).
Meat, chicken, and fish also provide iron and zinc. Use low fat cooking methods, such as stewing, baking, microwaving, grilling, slow cooking, or poaching.
See page 52 for our quick and easy wraps recipe.
Page 9
Nuts and pulses (plant protein) - Nati me ngā kai kākano nei te āhua (pūmua tipu)
Have at least one serving a day. Choose nuts and pulses (dried beans, peas, and lentils); for example baked beans, tofu, lentil burgers, bean salad, and lentil soup. A serving size is equal to ¾ cup of cooked legumes.
Pages 10 - 11
Carbohydrates / Warowaihā
Carbohydrates provide fibre, vitamins (for example vitamin C), and minerals, such as selenium. They are an important source of energy.
Breads and cereals - Parāoa me ngā pata kai
Try to have six servings of breads and cereals each day. These foods should form the basis of most meals and snacks.
Serving size examples are:
• ½ cup of cooked cereal or muesli, or one cup of cornflakes
• one cup of cooked rice, couscous, polenta, or pasta
• one roll, muffin, or slice of bread.
Also try semolina, sago, pikelets, scones, crackers, roti, chapatti, naan, plain biscuits, and other products made from grains. Ideally, they should be wholemeal or wholegrain, if tolerated, for additional fibre.
Page 12
Vegetables and fruits - Ngā huawhenua me ngā huarākau
Have at least five servings of vegetables and fruits each day. Vegetables and fruits provide a wide range of vitamins and minerals, as well as carbohydrates and fibre. Include a variety of colours and choose fresh, frozen, stewed, or canned. Serving size examples are:
• one medium potato, kumara, carrot, or equivalent piece of pumpkin, taro, or yams
• ½ cup of cooked vegetables; for example broccoli, peas, silverbeet, spinach, corn, peppers, carrot, courgette, cauliflower, cabbage, Brussels sprouts, bean sprouts, lettuce, puha, or watercress
• one tomato or a cup of salad
• one apple, pear, banana, or orange; two apricots, plums, kiwifruit, or mandarins, 1/2 cup of fresh, canned, or stewed fruits; three prunes, dates, or dried apricots.
See pages 54 to 57 for our roast vegetable medley and Waldorf salad with a difference recipes.
Page 13
Fats
Eat less of these foods or use sparingly, unless you are having difficulty maintaining your weight. You can choose from:
• butter, margarine
• oils, sour cream
• peanut butter
• coconut cream.
Fats provide energy and vitamins A, D, E, and K. If you are trying to lose weight, eat less of these foods or choose lower fat versions; for example lite coconut milk.
Page 14
Box:
Mōmona
Me iti ake te kai i ēnei momo kai me whakaomoomo rānei, atu i te tangata e noho tūpuhi ana. Pai noa iho te kōwhiri i te:
• pata, te margarine
• ngā hinu, te kirīmi kawa
• te pīnati pata
• te kirīmi kōkōnati.
Mā te mōmona ka whai kaha ka whai hoki i ngā huaora A, D, E, me te K. Mehemea kei te whakaheke koe i tō taumaha, kia iti ake te kai i ēnei kai, kia iti ake rānei te mōmona i roto i ngā kai, pērā ki te miraka kōkōnati lite.
End of Box
Page 15
Fluids (drinks)
Aim to drink eight glasses of water (1500ml) or other drinks each day (more if your cancer doctor recommends it). Limit alcohol, coffee, tea, and caffeinated drinks.
Box:
Ngā momo wai
Me kaha to inu ia rā, ia rā, kia 8 ngā karāhe wai (1500ml), aha atu inu rānei (nui ake mēnā ka tohua e tō rata). Kia iti ake te inu kawhe, inu tī, me ngā inu caffeine.
End of Box
Page 16
Vitamins and minerals
These help your body use the food you eat. The best source of vitamins and minerals is food. If you follow the guidelines outlined here, it is unlikely that you will need vitamin and mineral pills unless you are found to be lacking in something.
Box:
Ngā huaora me ngā manawa whenua
Ka āwhina ēnei i tō tinana ki te whakamahi i ngā kai ka kainga e koe. Ko te matamata pai mō ngā huaora me ngā manawa whenua, ko te kai. Ki te whai koe i ngā aratohu kua takoto i konei, e kore pea koe e hiahia i ngā pire huaora, manawa whenua hoki, inā rā, mei kore koe e mate i te hiahia mō tētahi mea.
End of Box
Some people believe that if a little bit of a nutrient is good for you, then a lot must be better. There is no scientific evidence to support this idea. High doses of some nutrients can have harmful effects and some vitamins, herbal supplements, and minerals should not be taken during treatment. Discuss with your cancer doctor or dietitian any vitamin and mineral supplements you are taking or think you should be taking.
Page 17
Food safety
Food safety is of special importance to cancer patients, especially during treatment that may suppress immune function. To make food as safe as possible it is recommended that patients follow the guidelines below:
• Wash hands thoroughly before eating.
• Keep all aspects of food preparation clean, including washing hands before preparing food, and washing fruit and vegetables.
• Handle raw meat, fish, poultry, and eggs with care, and clean thoroughly any utensils and surfaces that have been in contact with these foods. Keep raw meats separate from cooked food.
• Cook meat, poultry, and fish thoroughly, and use pasteurised milk and juices.
• Cover and refrigerate food promptly to minimise bacterial growth.
• When ‘eating out’, avoid foods that may have bacterial contamination, such as salad, sushi, and raw or undercooked meats, fish, poultry, and eggs.
• If there is any concern about the purity of your water, for example if you have well or tank water, have it checked for bacterial content and boil before use.
• To purify water, boil for at least a minute if you have any concerns.
Page 18
Box:
Kai haumaru
He mea tino nui mō ngā tūroro matepukupuku te kai haumaru ā, ko te wā tino nui rawa atu, ko te wā o te maimoatanga, nā tōna kaha pēhi i te mahi whakaturi mate.
Kia noho haumaru ai ngā kai, me whai ngā tūroro i ēnei aratohu e whai ake nei:
• Āta horoia ō ringaringa i mua i te kaitanga.
• Kia mā tonu ngā mea katoa e pā ana ki te whakataka kai, tae noa ki te mahi horoi ringaringa i mua i ngā mahi whakataka kai, me te horoi huarākau, huawhenua hoki.
• Me tūpato i te wā mahi ai i te taha o ngā mīti, ngā heihei me ngā hēki, ā, me āta horoi hoki ngā wāhi i pā ngā kai nei. Me noho wehe ngā mīti mata i ngā kai māoa.
• Me tino māoa te tunu i ngā mīti, ngā ika me te whakamahi i te waiū pasteurised.
• Kia tere te uwhi i ngā kai ka rau ki roto i te whata mātao kia iti ake te tipu o te kitakita.
• I ngā wā puta ki ngā wharekai kai ai, me tūpato ki ngā kai ka pā te kitakita, pērā ki ngā wāhi kai huamata, ki ngā kai sushi me ngā kai mata pērā ki te mīti mata, te ika mata me te hēki mata.
• Mehemea he paku raru e pā ana ki te pai o te wai, pērā ki ngā wai i roto i te puna, i roto i te taika pupuri wai rānei, whakaritea kia tirohia te nui o te kitakita kei roto, ka pāera i te wai i mua i te whakamahia.
• Hei whakapai i te wai, me pāera mō te nui ake i te kotahi meneti, kia kore ai koe e māharahara.
End of Box
Page 19
Staying the same weight
Ideally, you should stay at the same weight you were before you had cancer, but you may find it difficult to maintain your weight during treatment. If you were a little overweight before you had cancer, you might think that it will not hurt to lose a few kilos. However, losing weight during treatment can be harmful. The effects of your cancer and of reduced activity may be that this weight is lost from muscles rather than from fat stores. If you maintain your weight, it can help you recover better from the effects of cancer and its treatment.
If you are losing weight, include frequent meals and snacks in your diet. Also include some of the high energy foods listed in the following pages.
You should talk to your nurse, cancer doctor, or radiation therapist if you are concerned about your weight: they can arrange an appointment with a dietitian.
Pages 20 - 21
Foods high in calories (energy) and protein
Use these foods when you are not eating well or you are losing weight.
Butter, margarine, oil, mayonnaise, dressings, avocado, coconut cream
Use with bread, rice, pasta, vegetables, when frying, in salads, dips, and in curries, or casseroles if you can tolerate these foods.
Milk, skim milk powder, cream, ice cream, evaporated or condensed milk, cheese, sour cream, cream cheese
Use in puddings, fruit, cereals, sauces, soups, in casseroles, on vegetables, in salads, on biscuits, and in drinks.
Box:
Double strength milk
Sprinkle three tablespoons of skim milk powder into 600ml (one pint) of milk and whisk until the powder is dissolved.
End of Box
One or more of the following can be blended into a glass of milk:
yoghurt, ice cream, skim milk powder, mashed/pureed fruit, powder/liquid flavourings, essences, cordial.
Nuts and dried fruit
Snack on these between meals or add to cereals, puddings, and salads.
Pages 22 - 23
See page 58 for our ready to go snack recipe.
Tofu
Add to soups, vegetables, and dried bean dishes.
Peanut butter, honey, jam, marmalade, golden syrup
Spread on bread, crackers, and baked products. Add to porridge or puddings.
Sugar
Add to drinks, desserts, and cereals. Use ordinary cordials and fizzy drinks rather than ‘diet’ or low calorie versions.
Eat cakes, biscuits, baked products, chocolate, and sweets between or after meals.
Pickles, chutneys, pate, hummus, and other dips
Add to crackers, bread, and in cooking.
Fluids
Choose fluids that provide energy; for example milky drinks, cordials, non-diet drinks, soups, and juices.
Page 24
Adding to what you can eat (nutritional supplement drinks)
These are not a meal replacement. They should be used in addition to meals and snacks when you need to gain weight, or if you are not eating normally. These provide all the major nutrients found in food, and vitamins and minerals.
Some brand name supplements are listed below. They are available from supermarkets and pharmacies. Those marked with an * can be obtained on prescription, but you will need to have a ‘special authority number’, which your cancer doctor can arrange. If you think you would benefit from these products, talk to your cancer doctor or nurse.
Powders that are mixed with milk or water
• Complan
• Vitaplan
• Sustagen classic.
These can be purchased from a supermarket. They do not meet all your nutritional needs.
• Ensure powder *
• Sustagen hospital formula. *
Page 25
Ready-made drinks (funded only for those having tube feeding)
• Ensure Plus *
• Fortisip *
• Fortisip Multi Fibre. *
These are lactose free, and provide all your nutritional needs if consumed in the right quantity.
Fortified fruit juice
These juices do not meet all your nutritional needs, but do supply additional calories, protein, and carbohydrates. These juices are not available on prescription.
• Enlive
• Fortijuce.
Page 26
Eating problems
If you are having or recovering from surgery or treatment, it is important to eat well. You may have some eating problems like a loss of appetite, nausea, taste and smell changes, and mouth or swallowing difficulties. Between your treatments, symptoms should improve, so take advantage of this and eat a variety of foods that you enjoy.
Tell your nurse, cancer doctor, or radiation therapist if you have not eaten well over the last few days.
Box:
Ngā raruraru e pā ana ki te kai
Mehemea e whai oranga ana koe i te wā o tētahi pokanga, tētahi maimoatanga rānei, he mea nui kia pai tō kai. Tērā pea ka whai atu ko tētahi mate e pā ana ki tō kaha ki te kai, pērā ki te kore hiahia ki te kai, te hia ruaki, te rerekē o te rongo i te kai, ki te horomi kai rānei. I ngā wā kāore koe i te whai i te maimoatanga, ko te tikanga ka pai ake koe, nā reira me kaha tonu tō kai i ngā momo kai pai katoa ki a koe. Mehemea ka hipa ngā rā me te kore pai o tō kai, me kōrero ki tō tapuhi, tō rata, tō kaituku iraruke.
End of Box
Listed on the following pages are some tips you may find helpful.
Page 27
Loss of appetite (not feeling hungry)
• Eat small, frequent meals and snacks rather than three big meals.
• Use a smaller plate and present meals attractively.
• Eat more at times you feel hungry.
• Serve your favourite foods often.
• If possible, eat with family or friends rather than by yourself, or try eating while watching TV or reading a magazine or newspaper to take your mind off the food.
• Choose fluids that provide calories rather than water, coffee, tea, or broth. Drink fluid after or in between meals, but not just before.
• Relaxing before meals can reduce anxiety.
• Try foods that are easy to eat; for example eggs, milk puddings, crackers, soups, spaghetti, macaroni cheese, chicken, fish, mashed vegetables, and fruit.
• Garnishing food with chopped herbs, watercress, onion rings, orange slices, nuts, or tomato wedges can make food more appealing.
• Chop food up into bite-sized portions to make eating less of an effort.
• Prepare enough for several servings when cooking so you can eat when you are hungry.
• Accept offers of meals from friends and family if you liv e on your own.
• Make use of ready-made foods.
• A short walk before a meal might make you feel hungry.
Page 28
Nausea (feeling sick)
• Not eating for an extended period of time can prolong nausea; therefore, try to eat small amounts regularly.
• Talk to your cancer doctor about anti-sickness drugs, and take them as directed.
• Keep up your fluid intake—sip drinks slowly or use a straw. Try ginger ale or lemonade, fruit juice, weak tea, yeast spreads made into broths, clear broths, fruit or vegetable juices, nectars, ice blocks, and ice chips.
• Eat your main meal at the time of day when you feel the best.
• Choose foods that do not have a strong smell.
• Try a short walk in the fresh air before eating or try some slow, deep breathing.
• Avoid fried, fatty foods, because they may make you feel worse.
• Dry foods such as toast or crackers might help (with drinks between meals).
• Rest after eating.
• Keep away from the kitchen if cooking smells put you off eating, or ask someone else to prepare your food.
• Generally, foods at room temperature have a mild smell compared with hot foods.
• Eat and drink slowly.
• Sit upright for meals and avoid tight clothing.
Page 29
Box:
Te hia ruaki
• E kore koe e hia ruaki ki te kore koe e kai mō te wā roa nā reira, me auau te kai ahakoa paku noa iho.
• Kōrero ki tō rata mō ngā whakapōauau patu mate, me te whai i ngā tohutohu mō te kai.
• Kia kaha te inu—engari me āta inu, me whakamahi ngongo rānei. Whakamātauria te inu paitu kanekane, ngā inu waireka, tī ngoikore nei, ngā momo hupa, ngā wai o te huarākau me te huawhenua, ngā poraka aihikirīmi me ngā kotakota hukapapa.
• Kainga tō kai matua i te wā o te rā e tino pai ana tō āhua.
• Kōwhiria ngā kai kāore i kaha te haunga.
• Me paku hīkoi ki waho i mua i tō noho ki te kai, me whakahā pōturi me te hōhonu ake rānei.
• Me karo ngā kai parai me ngā kai mōmona, i te mea ka kino ake tō āhua.
• Tērā pea he pai te kai i ngā kai maroke pērā ki te tōhi, ki te pihikete pakapaka i waenganui i ngā kai nui (me te inu hoki).
• Me whakatā i muri te kai.
• Kaua e noho ki te kīhini mēnā he anuanu te kakara o ngā kai e tunu ana, me tono rānei i tētahi atu hei tunu i ō kai.
• Ko te tikanga, he iti ake te kakara o ngā kai mehemea kei te rite te pāmahana ki te rūma inā, ka whakaritea ki te kai wera.
• Me pōturi ake te kai i ō kai.
• Me tūtika te noho ki te kai, kaua e mau kākahu kikī rawa.
End of Box
Page 30
Taste and smell changes
Your treatment may cause your sense of taste or smell to change temporarily. You may not like foods which you once enjoyed, or find that you enjoy food which you previously disliked.
Here are some ideas that may help:
• Experiment with flavourings, such as lemon juice, herbs, chutneys and pickles, spices, pepper, celery salt, chocolate, fruit, or cheese.
• Add a little salt to foods that taste too sweet, and sugar to foods that are acidic (sour) or too salty.
• If you have lost your taste for meat, try marinating meats using soy sauce, honey, ginger, fruit juice, or wine before cooking. Or try canned or fresh fish, eggs, beans, nuts, lentils, or cheese instead.
• If your taste for salt is increased, eat small quantities of meats, such as corned beef, sausages, luncheon meat, bacon, ham, salty savouries, olives, anchovies, tinned or smoked fish, smoked chicken, tasty or feta cheese.
• Use fruit or fruit puree in ice cream or desserts, junket, milkshakes, or puddings to add extra flavour.
Page 31
Box:
Ka rerekē tō rongo me tō hongi kai
Tērā pea ka rerekē tō rongo i te kakara o te kai i te wā o tō maimoatanga. Tērā pea, kāore koe e pīrangi ki ētahi kai e pai ana ki a koe i ngā rā ki mua, ā, kua hiahia hoki koe ki ngā kai kāore koe i pīrangi i ngā rā ki mua.
Anei he whakaaro tērā pea ka āwhina i a koe:
• Whakamātauria ngā pūkara, pērā ki te wai rēmana, ngā rauamiami, ngā chutneys, me ngā pīkara, ngā namunamuā, te pepa, te tote hārere, tiakarete, huarākau me te tīhi.
• Poua he tote ki te ngā kai mēnā he reka rawa, me te huka ki ngā kai kawa rawa, totetote rawa rānei.
• Mehemea kua ngaro tō hiahia kai mīti, whakamātauria te pūkarakara mīti mā te whakamahi i te wairanu soy, te mīere, te paitu kanekane, te wai huarākau, te waina i mua i te tunutanga rānei. Whakamātauria rānei te ika kua puototia, te ika mata, te hēki, ngā pīni, ngā nati, ngā lentils, te tīhi rānei.
• Mena kua piki tō hiahia mō te tote, kainga he paku mīti, pērā ki te mīti kau mina-tote, te tōtiti, mīti luncheon, pēkana, poaka tauraki, mākarakara totetote, he oriwa, he korowhāwhā, ika mina-auahi te ika puoto rānei, heihei mina-auahi, tīhi reka, tīhi feta rānei.
• Raua he huarākau ki roto i te aihikirīmi, te purini rānei, te junket, ngā milkshakes, hei whakapūkarakara.
End of Box
Pages 32 - 33
Mouth or swallowing problems
There may be times when eating is physically difficult. You may have difficulty chewing or moving food around your mouth, difficulties swallowing, or pain in your mouth or throat.
Here are some tips to help:
• Avoid foods that may sting your mouth, such as acidic or highly spiced foods; for example pineapple, kiwifruit, citrus fruits, tomatoes, spicy and salty foods, very hot or icy cold foods and drinks.
• Avoid rough and crunchy foods, such as nuts, chips, and hard toast.
• Add dressings and sauces to make food moist.
• Try drinking liquids through a straw.
• Cook meat until very tender so you do not have to chew so much.
• It is important to keep your mouth clean to prevent infection and dental decay. It will help to clean your teeth with a soft toothbrush, and use a mouthwash after each meal. Check dentures are well-fitting. Ensure dentures are sterilised regularly to avoid infection.
Page 34
Box:
Mouthwash recipe
1 teaspoon salt
1 teaspoon baking soda
4 cups water
Add lemon juice for flavour if desired (although this may sting if your mouth is tender and sore).
End of Box
If your mouth is too sore to eat adequately, pain relievers may help. Ask your cancer doctor or nurse for their advice.
Dry mouth
• Serve drinks with meals. Sip when eating.
• Suck on ice blocks to provide moisture. Ice blocks will also help you to make saliva.
• Tart foods and drinks may also encourage the flow of saliva.
• Try pineapple juice or lemon juice in ice blocks for a refreshing mouthwash.
• Avoid dry foods. Add gravy, sauce, custard, cream, milk, melted butter, oil, or dressing to make food moist.
Lemon juice is highly acidic and long-term use can lead to tooth decay.
Page 35
Box:
“I have found that the dry mouth that followed radiation treatment on my tongue had two quite separate effects.
The most obvious one is that I have less saliva. This is very easily addressed by sipping drinks while eating. The second, though, is less well understood. My saliva is now less able to disperse the fibres that are being chewed. This means that some food tends to wad in my mouth and is difficult to swallow. Sipping a drink helps a bit but the real gains come from including a natural ‘saliva substitute’, such as white sauce or mashed potato.
The foods that are most prone to wadding are salad greens, boiled rice, instant pasta, chicken breast, steak (unless very tender), and firm-fleshed fish. I love all of these but have difficulty eating them by themselves. I find it easiest to do so if they are served with potato or a white (flour-based) sauce.
Other tips
When the rice is prepared as risotto or a creamed rice dessert, its consistency is changed and there is no problem.
Instant pasta, such as spaghetti or lasagne is fine if they are part of a dish that has a sauce.
Cook a chicken breast in a way that retains its moisture and serve with potatoes or a white sauce.”
Brian
End of Box
Page 36
Making food easier to eat
Changing the texture of foods can make it easier to chew and swallow.
Soft foods
These are foods that are soft enough so that they can be cut with the side of a fork. Vegetables may need to be cooked for longer, and meat or chicken cooked longer on a lower heat with liquid to make them soft and tender.
Here are some soft food suggestions.
Soups
• Smooth with no hard lumps.
Eggs
• Scrambled, poached, boiled, or made into an omelette.
• Quiche or soufflé.
• Cooked sliced egg in a cheese sauce, or mild curry sauce with rice.
Milk and milk products
• Dairy food, yoghurt, ice cream, milk puddings, soft cheeses, and cheese sauce.
• Avoid hard cheeses or those with dried fruit or nuts in them.
• Avoid grilled cheese that has gone hard.
Page 37
Fish
• Fish in white sauce/ cheese sauce/ parsley sauce.
• Convenience foods—boil in the bag, fish fingers, fish nuggets, canned tuna/ smoked fish/ salmon.
Chicken
• Boiled/ steamed/ microwaved/ roasted, or rotisserie, and diced with gravy, white sauce, mushroom sauce, cheese sauce, other sauces, or mashed potato.
Meat
• Boiled, stewed, roasted, grilled, and diced or sliced, served with gravy, mint sauce, redcurrant jelly, mustard sauce, other sauces, or mashed potato.
• Cold meats—ham, pork and apple sauce, ham and chicken.
• Mince with spaghetti, meat balls, potato top pie, and hamburger patties.
See page 60 for our mince pasta dish recipe.
Breads and cereals
• Soft breads without crusts with soft fillings; for example ham, egg and grated cheese and pineapple, minced chicken and mayonnaise, canned fish, and smooth peanut butter, or asparagus.
Pages 38 - 39
Fruit and vegetables
• Fresh, stewed, or canned fruit and vegetables.
• Soften by chopping, mashing, or grating.
Snacks
• Baking—biscuits or cakes; for example shortbread, sponge or Madeira cake, fruit loaf, muffins, pikelets, scones, and crackers.
Pureed foods (food with no lumps)
Use a blender, stick blender, or food processor to puree foods so that they have a smooth texture with no lumps.
Method
• Food processor—if you do not have a blender, stick blender, or food processor, a mouille and strainer can produce similar results, but it will take more time.
• Add liquid (ideally, use a nutritious liquid; for example gravy, full fat milk, white sauce, soup, cream sauce, or fruit juice rather than water). Continue adding more liquid until the desired consistency is reached.
• Blend until the mixture is smooth with no lumps.
Pages 40 - 41
Tips
• Some fibrous fruit and vegetables (for example peas, corn, celery, onions, and pip fruits) may not puree very easily. Try straining after pureeing and they may be soft enough.
• Individual flavours and colours of a meal can be preserved better when vegetables and meat are pureed separately.
• Pureed meat often loses its colour and flavour—try adding tomato, soya, or Worcestershire sauce, herbs, mushrooms, or tomatoes. Serve meats with gravies, sauces, or jellies; for example mint sauce or redcurrant jelly with lamb. Pureed meals can be frozen. Thaw in the fridge and heat thoroughly, add a little more liquid if necessary. If stored in the refrigerator, pureed meals will keep for only 12 hours.
• Green vegetables can look unappealing when pureed. Try mixing with a little mashed potato or instant potato flakes. Tasty pureed vegetable combinations include swede and carrot, carrot and parsnip, and beans and parsnip.
Page 42
Bowel problems
Treatment can alter your normal bowel habit causing constipation or diarrhoea. Consult your cancer doctor if symptoms persist. (These recommendations need to be adjusted for people with some types of cancer; for example bowel cancer.)
Constipation (hard bowel motions)
If you are constipated, increasing the fibre content of your diet can help:
• Eat regular meals.
• Do some exercise each day.
• Increase the amount you drink. Aim for 8 to 10 glasses each day. Hot drinks may help.
• Ensure you are having 5+ servings of fruit and vegetables each day. Eat raw or cooked.
• If too much wind is a problem, try avoiding vegetables that may cause wind or discomfort, such as cabbage, onions, cucumber, peas, and baked beans, and limit fizzy drinks.
• Choose wholemeal or wholegrain breads and cereals; for example porridge, Weetbix, All Bran, muesli, wholemeal bread, wheat germ, bran biscuits, or muffins. Use wholemeal flour for baking or in sauces.
See page 63 for our fruit kebabs with yoghurt and honey dipping sauce recipe.
Page 43
• Commercial products, such as Kiwicrush, Benefiber, Metamucil, or Stimulance may be useful.
• Kiwifruit, prunes, and their juices are helpful in preventing constipation.
• Add extra fibre to your food; for example one or two teaspoons of wheat bran flakes or oat bran daily. This can be gradually increased to an amount that will give you a regular bowel habit. The bran can be added to cereals or used in cooking. When you use bran to increase your fibre it is important to increase your fluids as well.
Prune mix
Try some of this prune mix daily.
Ingredients:
1 cup pureed apple
1 cup bran flakes
½ cup softened prunes
1 cup prune juice
Directions:
Puree together using a blender, stick blender, or food processor, and serve two to three tablespoons with breakfast daily.
Page 44
Diarrhoea (loose bowel motions)
Some chemotherapy drugs cause severe diarrhoea. If you have diarrhoea, contact your cancer doctor or nurse immediately. Following an acute bout, gradually start eating bananas, rice, apples, and toast.
• Drink more to replace lost fluids. Choose from diluted fruit juice, flat soft drink, vegetable juice, vegetable broth, weak tea, and nutritional supplements. Aim to drink at least eight glasses (1500ml) of fluid daily.
• Eat small, frequent meals.
Box:
Kōrere (mate tikotiko)
Ka puta te mate kōrere kino rawa atu nā ētahi o ngā whakapōauau hahau. Ki te pāngia koe ki te mate kōrere, me kakama tonu te whakapā atu ki tō rata matepukupuku, tō tapuhi matepukupuku rānei. Whai muri i te mate tikotiko me tīmata ki te kai panana, raihi, āporo me te tōhi.
• Kia kaha te inu hei whakahoki i te wai kua ngaro. Me kōwhiri mai i te wai huarākau kua waimehatia, te inu waireka kore mirumiru, inu huawhenua, wairenga huawhenua, tī ngoikore me ngā tāpiringa kai tōtika. Me whai kia 8 ngā karāhe inu (1500ml) i ia rā ia rā.
• Kia iti te kai engari kia maha tonu ngā wā kai.
End of Box
Page 45
What is a low fibre diet?
Your dietitian or cancer doctor may advise you to eat a low fibre diet. A low fibre diet is when you have less of or none of these foods:
Breads and cereals
Breads that contain whole grains, nuts, seeds, and kibbled wheat; cereals, such as muesli, which contain nuts, seeds, or dried fruit; and brown rice or pasta.
Fruit
Fruits with seeds, pips, pith, or hard skins; for example kiwifruit, berries, apples, citrus fruits, and dried fruit.
Vegetables
Vegetables with hard skins, seeds, or stalks; for example corn, celery, vegetables from the cabbage family, onions, cucumbers, garlic, peas, and broad beans.
Nuts and seeds
Crunchy peanut butter, nuts, and seeds—whole or chopped.
Meat, fish, poultry, eggs, and pulses
Tough, gristly meat, fried meat, fish, or poultry, fatty or highly seasoned meats, such as sausages, curry, prepared dried meals, fried eggs, baked beans, and pulses.
Page 46
Other foods or drink that may make diarrhoea worse:
Drinks
Alcoholic drinks, strong tea, or coffee.
Fat
Rich sauces, highly seasoned dressings, rich pastry, batter, and fried foods. Any new foods should be introduced one at a time, so that you can check their effect. You can gradually return to a normal diet.
If you have severe diarrhoea, see your cancer doctor. A low residue diet may be recommended.
Box:
Mōmona
Ko ngā wairanu mōmona, ngā wairanu huamata, ngā pōhā mōmona, te kaihau me ngā kai parai. Me āta kai i ngā kai hōu, kia paku noa iho i ia wā kia pai ai tō whakamātau i tōna pānga. A tōna wā ka hoki ki tōu ake kaha ki te kai.
Ki te kaha pāngia koe ki te mate tikotiko, haere ki te kite i tō rata. Tērā pea, ka taunakitia tētahi nohopuku iti ake te paranui.
End of Box
Page 47
Eating a low residue diet
This is the same as a low fibre diet plus the points below:
• If you experience cramping pains, bloating, and diarrhoea (these can result if lactose (milk sugar) is not digested), you could try limiting the amount of cow’s milk you drink to 300ml daily. Hard cheeses are usually well-tolerated. Cow’s milk should be replaced with soy or rice milk, or nutritional supplement drinks. You will be able to tolerate lactose again after the diarrhoea has settled. Cow’s milk may then be re-introduced. Many people do tolerate milk products, and they should only be avoided if not tolerated on a regular basis.
• It is wise to limit fruit and vegetables to three servings a day. All fruit and vegetables should be peeled and cooked without pips or seeds. You do not need to limit the fruit and vegetable juices you drink.
• Use white bread for toast and sandwiches. Use cream crackers and water crackers for snacks. Only use baked or cereal products made from white flour; for example white rice, noodles, spaghetti, cornflakes, and rice bubbles. Avoid pepper, curries, foods containing spices, alcohol, and fatty foods.
• Re-introduce foods one at a time so that you can judge their effect.
Page 48
Intolerance to some foods (food that makes you feel unwell)
If you have had bowel surgery, you may find for a time that your body can no longer tolerate some foods that were a part of your diet. It will take time for your body to adjust to the changes made by the surgery but, usually, it will slowly return to a normal or near normal state. After a time (it may take some weeks or months), slowly introduce a new food into your diet. Try one new food at a meal, and start with a teaspoonful. Once you find that your body accepts the new food, you can increase the quantity. You will then be able to do the same for another new food.
Fatigue
You may experience extreme tiredness (fatigue) during or after surgery/treatment:
• Eat small frequent meals.
• Have a variety of foods to keep meals interesting and appetising.
• Remove rules around eating.
• You may find nutritional supplements useful (see page 24 for more information).
Use ready prepared foods, have two to three pre-prepared meals in the freezer for treatment days or days that you have a lot of appointments.
For more information on managing your fatigue, read our Information Sheet “Cancer-Related Fatigue” on the Society’s website (www.cancernz.org.nz).
Page 49
Easy ways to make meals
• Prepare and freeze extra meals when you are feeling better to save time and effort when you are not feeling so well.
• Keep stocks of convenience foods—‘ready to prepare’ noodle or rice dishes, spaghetti, baked beans, canned fish, packet or canned soups, instant gravy or sauce sachets, eggs, cheese, milk, canned or packet dessert foods.
• Use the freezer to store bread, pizza, pies, fish, meat and chicken portions, frozen vegetables, and individual meals.
• Use the microwave oven to cook vegetables quickly, and to reheat leftovers and frozen convenience foods.
Keep stocks of nutritious fluids, such as nutritional supplement drinks, fruit juice, and milk.
Pages 50 - 51
Recipes
Fruit smoothie
Have your favourite fruit and increase your bone health at the same time. Experiment with your favourite fruit to create your ultimate quick and easy snack.
Ingredients:
1 pottle low fat berry yoghurt
1 banana
1 cup trim milk
1 drop of coconut essence
1 teaspoon flavoured milkshake mix
Directions:
Place all of the ingredients in a blender. Blend until smooth.
Serve in a tall glass with a straw and, if desired, garnish with a sprig of mint.
Cook’s tip:
Add your favourite fruit into the mixture to suit your taste buds.
If you choose not to have cow’s milk products, calcium fortified soy or rice products should be included as substitutes.
Page 52
Quick and easy wraps
Wraps are so versatile and easy, perfect as a snack, or a meal on the run.
Ingredients:
1 packet of wholemeal tortilla or naan bread (wraps)
1 Tablespoon oil
1 onion, sliced
400g pork, cut into bite-sized pieces
1 Tablespoon soy sauce
2 carrots, grated
2 cups cabbage, shredded
⅓ cup red capsicum, diced
⅓ cup green capsicum, diced
½ cup Edam cheese, grated
2 Tablespoon balsamic vinegar
100g hummus
2 Tablespoons sweet chilli sauce (optional)
Directions:
Place the vegetables and cheese in a large bowl. Mix well. Toss in the balsamic vinegar and set aside.
Heat the oil in a fry pan on a medium heat. Brown the onion and then add in the pork. Add in the soy sauce and stir regularly. Cook the pork until the meat is browned. The inside of the meat should be white right through, and the juices run clear.
Place the wrap on a plate and heat in the microwave for 10 seconds. Spread a teaspoon of the hummus and chilli sauce onto the centre of the wrap. Place a small portion of the pork and vegetables in the middle of each wrap, fold in the edges, and roll up.
Page 53
Cook’s tip:
There is an endless list of fillings you can put into a wrap. Try adding stir-fries, falafel, refried beans, other cuts of meat, salads, and rice. This way, each wrap will be slightly different each time.
Page 54
Roast vegetable medley
Jazz up your roast vegetables by adding a variety of different vegetables, adding colour, flavour, and a boost of anti-oxidants.
Ingredients:
4 small-medium sized potatoes (skin on and scrubbed with a scourer to remove dirt)
1 kumara (skin on and scrubbed)
¼ pumpkin
2 carrots
1 parsnip
1 celery stick
2 courgettes
1 bulb of garlic
Favourite herbs (optional)
Iodised salt and pepper to taste
2 Tablespoon oil
Directions:
Preheat oven to 220°C.
Chop the vegetables into manageable sized chunks. Try to keep all of the vegetables around the same size for even cooking with the exception of the carrots and celery which can be bigger.
Arrange all of the vegetables except the celery in a large roasting dish. Do not put the vegetables in the same dish with any roast meats. Pour over oil and toss to cover all of the vegetables. Season with salt, pepper, and herbs to taste.
Page 55
Bake for 30 minutes before adding the celery and bake for a further 20 minutes or until golden and soft. Remove from the oven and allow to cool for 5 minutes. Serve with roast meats, fresh steamed green vegetables, and gravy.
Cook’s tip:
Cook the vegetables in their own dish.
Pages 56 - 57
Waldorf salad with a difference
This is a healthier option to the classic waldorf salad which has a high energy, creamy mayonnaise. This version is better for you, and still full of flavour.
Ingredients:
2 apples, chopped and left unpeeled
1 lemon, juiced
5 celery sticks, roughly chopped
1 carrot, chopped
1 cup grapes
100g feta cheese, cubed
Salt and pepper to taste
¼ cup vinaigrette or balsamic vinegar
½ cup parsley leaves (optional)
½ cup pumpkin and sunflower seeds (optional)
¾ cup walnuts, roughly chopped
Directions:
Place the apples in a large mixing bowl and toss through the lemon juice. Then add the other ingredients.
Place in the fridge or serve immediately as a side or a light main dish. Garnish with pumpkin and sunflower seeds.
Cook’s tip:
Don’t forget to put the lemon juice on the apples or they will turn brown.
Page 58
Ready to go snack
Jam-packed with energy, this snack is super easy to make and perfect for school lunches or a snack on the go.
Ingredients:
1 cup mixed, dried nuts
2 cups mixed, dried fruit
½ cup pumpkin seeds
½ cup sunflower seeds
½ cup chocolate buttons, roughly chopped
¼ cup shredded coconut
Directions:
Mix all of the ingredients in a large resealable bag or airtight container.
This can be portioned out into smaller containers or bags for midday snacks or served in a bowl for guests.
Cook’s tip:
Keep your portions to a minimum. Dried fruit can be deceiving. Remember that fresh fruit shrinks a lot as it dries so a small handful of dried fruit contains the same energy as the full-sized fresh fruit. Nuts and seeds also contain a lot of energy.
Page 60
Mince pasta dish
This one-pot-wonder is a great way of preparing a nutritious meal. It’s also a great comfort food with leftovers to freeze for another night.
Ingredients:
1 Tablespoon oil
2 onions, chopped
3 garlic cloves, minced
3 celery sticks, chopped
1kg minced beef
100g tomato paste
3 cups beef stock
3 carrots, sliced
2 cups broccoli florets
¾ cup corn kernels—fresh, frozen, or canned
2 cups pasta shells
1 teaspoon basil
¾ cup red capsicum, chopped
¾ cup green capsicum, chopped
Iodised salt and pepper to taste
2 teaspoon cornflour (optional)
Parsley and grated Parmesan or Edam cheese garnish (optional)
Directions:
Heat the oil in a large saucepan on a medium to high heat. Brown the onions, and then the mince before adding in all of the other ingredients, with the exception of the capsicums and mix well.
Simmer the ingredients for 10 minutes before adding in the capsicums. Cook for a further 5–10 minutes or until the pasta is al dente (almost soft) and the vegetables are soft.
Page 61
Add more water if needed. You want enough fluid to just cover the ingredients, allowing the pasta and vegetables to simmer and prevent the ingredients sticking to the bottom of the saucepan. If the mixture becomes too watery, combine cornflour and a small amount of cold water and add into the mince mixture.
Mix well.
Serve with grated Edam or Parmesan cheese and fresh parsley.
Cook’s tip:
Use different vegetables depending on the season, such as leeks in winter, and courgettes in summer, or add frozen mixed vegetables.
Pages 62 - 63
Fruit kebabs with yoghurt and honey dipping sauce
Fruit kebabs are a simple but effective way to make fruit look appealing. Encourage your kids to help make them— they’re easy.
Ingredients:
1 cup plain yoghurt 2 Tablespoon honey
Use your favourite fresh fruit
1 red apple, diced (core removed, skin on)
1 banana, chopped into 2cm thick chunks
10 grapes
2 mandarins, broken into segments
3 kiwifruit, cut into chunks
1 Tablespoon lemon juice
6 bamboo skewers
¼ cup favourite unsalted, unroasted nuts (optional)
Sprig of mint, garnish
Summer suggestions: strawberries, melons, apples, kiwifruit, peaches, oranges, cherries.
Winter suggestions: apples, bananas, pears, mandarins, kiwifruit, grapes, persimmons.
Directions:
Place the honey in a heatproof cup and heat in the microwave for 30 seconds, or until it has become runny. Allow to cool for a minute, before mixing the honey into the yoghurt.
Page 64
Cut the fruit into chunks. Place apple and banana in a plastic bag. Pour in the lemon juice. Mix the ingredients in the bag to coat the fruit with lemon juice to prevent it from browning.
Thread the fruit and nuts onto the skewers, alternating between the different types of fruit making a colourful pattern.
Serve with the yoghurt dipping sauce, or pour the yoghurt mix over the kebabs and add the mint to garnish.
Cook’s tip:
For the best effect, these will need to be prepared right before serving. Make up a huge platter of fruits and vegetables and encourage everyone to make their own with their favourite fruits.
Page 65
Suggested reading and websites
Reading
Beliveau, Richard and Gingras, Denis. (2007) Foods to Fight Cancer. Australia: DK Publishing.
Besser, Jeanne et al. (2009) What to Eat During Cancer Treatment. Atlanta: American Cancer Society.
Buckman Weinstein, Jodi. (2010) Tell Me What to Eat Before, During and After Cancer Treatment. USA: New Page Books.
Clegg, Holly and Miletello, Gerald. (2006) Eating Well Through Cancer. USA: Favorite Recipes Press.
Gourley, Glenda. (2010) The New Zealand Vegetable Book. New Zealand: Hyndman Publishing. (There’s also a good website (www.vegetables.co.nz).)
Grant, Barbara, L. et al. (2010) American Cancer Society Complete Guide to Nutrition for Cancer Survivors (2nd ed.). Atlanta: American Cancer Society.
Katzin, Carolyn. (2011) The Cancer Nutrition Center Handbook—An Essential Guide for Cancer Patients and Their Families. Los Angeles: CFK.
van Mil, José. (2008) Healthy Eating During Chemotherapy. USA: Kyle Books.
For more suggestions, visit your Cancer Society’s library or local library.
Page 66
Websites
American Institute of Cancer Research www.aicr.org/patients-survivors/
New Zealand Food Safety Authority Food Safety: When you have low immunity http://www.foodsmart.govt.nz/elibrary/lowimmunity.pdf
The suggested websites (other than our own) are not maintained by the Cancer Society of New Zealand. We only suggest sites we believe offer credible and responsible information, but we cannot guarantee that the information on such websites is correct, up-to-date, or evidence-based medical information. We suggest you discuss any information you find with your cancer care health professionals.
Pages 67 - 68
Notes
You may wish to use this space to write down any questions for or advice given by your cancer doctors, nurses, or health providers at your next appointment.
Box:
Whakamahia tēnei wāhi wātea hei tuhi pātai e hiahia ana koe ki te pātai i tō rata, ngā tapuhi, ngā kaiwhakarato hauora rānei mō te wā e hoki atu ai koe.
End of Box
Page 69
Cancer Society of New Zealand Inc.
National Office
PO Box 12700, Wellington 6144
Telephone: (04) 494-7270
Auckland Division
PO Box 1724, Auckland 1140
Telephone: (09) 308-0160
Covering: Northland
Waikato/Bay of Plenty Division
PO Box 134, Hamilton 3240
Telephone: (07) 838-2027
Covering: Tauranga, Rotorua, Taupo, Thames, and Waikato
Central Districts Division
PO Box 5096, Palmerston North 4441
Telephone: (06) 364-8989
Covering: Taranaki, Wanganui, Manawatu, Hawke’s Bay, and Gisborne/East Coast
Wellington Division
52 Riddiford Street, Wellington 6021
Telephone: (04) 389-8421
Covering: Marlborough, Nelson, Wairarapa, and Wellington
Page 70
Canterbury/West Coast Division
PO Box 13450, Christchurch 8141
Telephone: (03) 379-5835
Covering: South Canterbury, West Coast, and Ashburton
Otago/Southland Division
PO Box 6258, Dunedin 9059
Telephone: (03) 477-7447
Covering: Urban and rural Otago and Southland
Cancer Information Service
Telephone: 0800 CANCER (226 237)
www.cancernz.org.nz
Page 71
Feedback
Eating well during cancer treatment / Kia pai te kai i te wā maimoatanga matepukupuku
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Please return to: The Information Manager, Cancer Society of New Zealand, PO Box 12700, Wellington.
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Information, support, and research
The Cancer Society of New Zealand offers information and support services to people with cancer and their families/whānau. Printed materials are available on specific cancers and treatments.
Information for living with cancer is also available.
The Cancer Society is a major funder of cancer research in New Zealand. The aim of research is to determine the causes, prevention, and effective methods of treating various types of cancer.
The Society also undertakes health promotion through programmes such as those encouraging SunSmart behaviour, eating well, being physically active, and discouraging smoking.
We appreciate your support
The Cancer Society receives no direct financial support from Government so funding comes only from donations, legacies, and bequests. You can make a donation by phoning 0900 31 111, through our website, or by contacting your local Cancer Society.
Acknowledgements
The Cancer Society would like to thank for their reviews, advice, and contributions:
Kathy Hamilton
Dietitian, Oamaru Hospital, Waitaki District Health Service and Otago HEHA Manager, Southern DHB
Helen Brown
Dietitian, Nurse Maude, Christchurch
Professor Lynette Ferguson
Auckland Cancer Society Research Centre, School of Medical Sciences, Head of Department of Nutrition, School of Medical Sciences, The University of Auckland
Dr Jan Pearson
National Health Promotion Manager, National Office, Cancer Society of New Zealand
Meg Biggs, Julie Holt, and Michelle Gundersen-Reid
Cancer Society Information Nurses
Associate Professor Chris Atkinson
Medical Director of the Cancer Society of New Zealand and Oncologist at St George’s Cancer Care Centre
Sarah Stacy-Baynes
National Information Manager
We thank the people who have experienced cancer who reviewed this edition, and offered many valuable suggestions. We also thank the Cancer Society volunteers who agreed to be photographed for our booklet.
Photography
This cover photo was taken by Moxie Communications.
Back Page
www.cancernz.org.nz
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End of Eating well during Cancer Treatment